The plantar plate is a fibrocartilaginous tissue beneath the metatarsophalangeal joint (MTPJ). Plantar plate function centers around maintaining the static stability of the MTPJ, and its integrity facilitates the dynamic stabilizing functions of surrounding soft tissue structures. Injury to the plantar plate can cause significant forefoot discomfort focused around the MTPJ, swelling, and altered forefoot biomechanics from toe instability. Significant injury like either partial or complete tear of the plantar plate commonly requires surgical intervention to repair the tissue. As fibrocartilage, the plantar plate lacks an intrinsic capacity for robust healing, thus requiring a surgical repair aiming to restore proper function. Existing plantar plate repair techniques afford different perspectives for restoring plantar plate biomechanical function, though room for improvement exists for an enhanced repair. Our senior design team developed a novel approach for plantar plate repair using a two-piece snap fitting permanent implant. This novel technique was reduced to practice and required further experimental analysis of its functional capacity to inform future development.
Two methodologies were used to evaluate the novel implant device designed for plantar plate repair. An implant isolated mechanical testing protocol was developed to evaluate the implant and suture construct of the repair in anatomically relevant orientations. A human cadaver tissue model protocol was employed to evaluate the integrity of the native plantar plate tissue, a simulated conventional repair, and our novel implant fixation repair. These methodologies used uniaxial tensile testing with custom test configurations to evaluate the structural integrity and properties of the implant-suture construct and simulated tissue only or tissue-repair constructs, respectively. Our results provided encouraging support for the use of mechanical testing and the continued development of this novel implant device for plantar plate repair. Additionally, qualitative outcomes from this testing revealed additional avenues to improve the novel implant device in support of further advancing the product for future use in the field of podiatric medicine. / Master of Science / The plantar plate is a soft, biological tissue that lies beneath the metatarsophalangeal joint (MTPJ), which comprises the ball of the foot. When injured, the plantar plate lacks capacity to fully heal the tissue, as its structural properties more closely resemble that of cartilage and ligaments, which also commonly fail to fully heal after injury. Due to the difficulties in facilitating healing and restoring its function, a plantar plate tear or rupture is commonly repaired surgically. Current methods for repairing a plantar plate tear vary, though room to enhance the overall surgical repair technique exists. Our senior design team developed a novel implant device for use in a modified surgical repair of the plantar plate, which aimed to improve upon the existing methods. This work focused on developing experimental methods to analyze and evaluate the function of this novel implant device that is relevant to the clinical application of plantar plate repairs.
Two experimental setups were developed and used to analyze the function of our novel implant device. A simulated repair setup, relevant to the natural function of the plantar plate, was employed to evaluate the function of the implant and suture used in the repair. A human cadaver model experimental setup aimed to evaluate the plantar plate naturally, a conventional or existing repair, and our novel repair of a simulated torn plantar plate. The outcomes from these experiments encourage further exploration of implant product development as well as continued testing of this device in the future. Ultimately, this work has provided a foundation for the continued development of our novel implant device for plantar plate repair with the aim to bring this product to market and enhance the field of podiatric medicine.
| Identifer | oai:union.ndltd.org:VTETD/oai:vtechworks.lib.vt.edu:10919/115875 |
| Date | 12 July 2023 |
| Creators | Dickinson, Logan Nicholas |
| Contributors | Department of Biomedical Engineering and Mechanics, Wang, Vincent M., Wayne, Jennifer S., Clements, John Randolph |
| Publisher | Virginia Tech |
| Source Sets | Virginia Tech Theses and Dissertation |
| Language | English |
| Detected Language | English |
| Type | Thesis |
| Format | ETD, application/pdf, application/pdf, application/pdf |
| Rights | In Copyright, http://rightsstatements.org/vocab/InC/1.0/ |
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