Biomechanical Evaluation of Hemiarthroplasty in the First Proximal Phalanx. A Finite Element Study


  • Mario Alberto Madrid Pérez Facultad de Ingeniería, Universidad Autónoma de Chihuahua, México
  • Ricardo Becerro de Bengoa Vallejo Universidad Computense de Madrid, Spain
  • Javier Bayod López Universidad de Zaragoza, Spain



Hallux Rigidus, First Metatarsophalangeal Joint, Hemiarthroplasty, Finite Element Analysis


Hallux rigidus produces a decrease in the dorsiflexion of the first metatarsophalangeal joint and is usually associated with the appearance of osteophytes. Hemiarthroplasty in the first proximal phalanx is a recommended surgical procedure in patients with advanced grade of hallux rigidus. Finite element analysis allows us to understand the biomechanical behavior of the foot. The objective of this work is to evaluate the biomechanical effects of an hemi implant placed in first proximal phalanx. Two models of finite elements are going to be compared, one free of pathologies and the other with a hemiarthroplasty in the first ray of the foot. We detected after inserting the prosthesis in the model that passive windlass mechanism is lost, and the lesser toes become overloaded, which leads to a loss of efficiency in gait as well as being able to cause postsurgical medical complications.


Download data is not yet available.


Núñez-Samper M, Llanos Alcázar LF. Biomecánica, medicina y cirugía del pie. Barcelona: Masson, S. A; 2000.

Polzer H, Polzer S, Brumann M, et al. Hallux rigidus: Joint preserving alternatives to arthrodesis - a review of the literature. World J Orthop [Internet]. 2014;5(1):6–13. Available from:

Asunción Márquez J, Martín Oliva X. Hallux rígidus: Etiología, diagnóstico, clasificación y tratamiento. Rev Esp Cir Ortop Traumatol [Internet]. 2010;54(5):321–328. Available from:

Martínez Bocanegra MA, Bayod Lopez J, Vidal-Lesso A, et al. Structural interaction between bone and implants due to arthroplasty of the first metatarsophalangeal joint. Foot Ankle Surg [Internet]. 2019;25(2):150-157. Available from:

Delman C, Kreulen C, Sullivan M, et al. Proximal Phalanx Hemiarthroplasty for the Treatment of Advanced Hallux Rigidus. Foot Ankle Clin [Internet]. 2015;20(3):503–512. Available from:

Perler AD, Nwosu V, Christie D, et al. End-Stage Osteoarthritis of the Great Toe/Hallux Rigidus. A Review of the Alternatives to Arthrodesis: Implant Versus Osteotomies and Arthroplasty Techniques. Clin Podiatr Med Surg [Internet]. 2013;30(3):351–395. Available from:

Morales-Orcajo E, Bayod J, Becerro-de-Bengoa-Vallejo R, et al. Influence of first proximal phalanx geometry on hallux valgus deformity: a finite element analysis. Med Biol Eng Comput [Internet]. 2015;53:645–653. Available from:

Kristen K-H, Berger K, Berger C, et al. The First Metatarsal Bone Under Loading Conditions : A Finite Element Analysis. Foot Ankle Clin [Internet]. 2005;10(1):1–14. Available from:

Madrid MA, de Bengoa Vallejo RB, López JB. Biomechanical Evaluation of Hemiarthroplasty in First Metatarsal Bone. In: González Díaz C, et al. (eds). VIII Latin American Conference on Biomedical Engineering and XLII National Conference on Biomedical Engineering CLAIB 2019 [Internet]. Cancún: IFMBE Proceedings; 2019:831–840. Available from:

Becerro de Bengoa Vallejo R, Losa Iglesias ME, Jules KT. Tendon Insertion at the Base of the Proximal Phalanx of the Hallux: Surgical Implications. J Foot Ankle Surg [Internet]. 2012;51(6):729–733. Available from:

Ramos AR. Estudio por elementos finitos del comportamiento del pie [dissertation]. [Zaragoza]: Universidad de Zaragoza; 2006. Spanish.

Moharrami N, Langton DJ, Sayginer O, et al. Why does titanium alloy wear cobalt chrome alloy despite lower bulk hardness: A nanoindentation study? Thin Solid Films [Internet]. 2013;549(31):79–86. Available from:

Çelik I. Influence of CrN Coating on Electrochemical Behavior of Plasma Nitrided Pure Titanium in Bio-simulated Environment. J Bionic Eng [Internet]. 2016;13:150–155. Available from:

Tanner KE. Titanium in Medicine. Proc Inst Mech Eng H [Internet]. 2002;216(3):215-215. Available from:

Morales Orcajo E.. Influencia de la geometría de la falange proximal en la formación de juanetes [master's thesis]. [Zaragoza]: Universidad de Zaragoza; 2012. Spanish.

Bayod J, Losa-Iglesias M, Becerro de Bengoa-Vallejo R, et al. Advantages and Drawbacks of Proximal Interphalangeal Joint Fusion Versus Flexor Tendon Transfer in the Correction of Hammer and Claw Toe Deformity. A Finite-Element Study. J Biomech Eng [Internet]. 2010;132(5):51002. Available from:

Bayod J, Becerro de Bengoa Vallejo R, Losa Iglesias ME, et al. Stress at the Second Metatarsal Bone After Correction of Hammertoe and Claw Toe Deformity: A Finite Element Analysis Using an Anatomical Model. J Am Podiatr Med Assoc [Internet]. 2013;103(4):260–73. Available from:

García-González A, Bayod J, Prados-Frutos JC, et al. Finite-element simulation of flexor digitorum longus or flexor digitorum brevis tendon transfer for the treatment of claw toe deformity. J Biomech [Internet]. 2009;42(11):1697–1704. Available from:

Marco Sanz C. Cinesiologia de la marcha humana normal [Internet]. Universidad de Zaragoza; 2011. Available from:

DeHeer PA. The Case Against First Metatarsal Phalangeal Joint Implant Arthroplasty. Clin Podiatr Med Surg [Internet]. 2006;23(4):709–723. Available from:

Giza E, Sullivan M, Ocel D, et al. First metatarsophalangeal hemiarthroplasty for hallux rigidus. Int Orthop [Internet]. 2010;34:1193–1198. Available from:

Konkel KF, Menger AG, Retzlaff SA. Results of Metallic Hemi-Great Toe Implant for Grade III and Early Grade IV Hallux Rigidus. Foot Ankle Int [Internet]. 2009;30(7):653–660. Available from:

Kirby K. Foot and lower extremity biomechanics, Vol. IV. Payson: Precision Intricast Newsletter ;1997. 142p.

García-Aznar JM. Bayod J, Rosas A, et al. Load Transfer Mechanism for Different Metatarsal Geometries: A Finite Element Study. J Biomech Eng [Internet]. 2008;131(2):021011. Available from:

Dolgov, N A, Dikova T, Dzhendov D, et al. Mechanical Properties of Dental Co-Cr Alloys Fabricated via Casting and Selective Laser Melting. Int Sci J Materials Science. Non-Equilibrium Phase Transformation. 2016;2(3):29–33.




How to Cite

Madrid Pérez, M. A., Becerro de Bengoa Vallejo, R., & Bayod López, J. (2021). Biomechanical Evaluation of Hemiarthroplasty in the First Proximal Phalanx. A Finite Element Study. Revista Mexicana De Ingenieria Biomedica, 42(2), 58–66.



Research Articles

Share on:

Dimensions Citation