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Mat Jais IS, Wong YR, McGrouther DA, Leo HL. Investigating the biomechanical behaviour of tendon-loaded wrist joint using web-like kinematic network model. J Biomech 2024; 172:112210. [PMID: 38950485 DOI: 10.1016/j.jbiomech.2024.112210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 06/17/2024] [Accepted: 06/24/2024] [Indexed: 07/03/2024]
Abstract
The complexity of wrist anatomy and mechanics makes it challenging to develop standardized measurements and establish a normative reference database of wrist biomechanics despite being studied extensively. Moreover, heterogeneity factors in both demographic characteristics (e.g. gender) and physiological properties (e.g. ligament laxity) could lead to differences in biomechanical behaviour even within healthy groups. We investigated the kinematic behaviour of the carpal bones by creating a virtual web-like network between the bones using electromagnetic (EM) sensors. Our objective was to quantify the changes in the carpal bones' biomechanical relative motions and orientations during active wrist motion in the form of orb-web architecture. Models from five cadaveric specimens at different wrist positions: (1) Neutral to 30° Extension, (2) Neutral to 50° Flexion, (3) Neutral to 10° Radial Deviation, (4) Neutral to 20° Ulnar Deviation, and (5) Dart-Throw Motion - Extension (30° Extension/10° RD) to Dart-Throw Motion Flexion (50° Flexion/20° UD), in both neutral and pronated forearm have been analyzed. Quantification analyses were done by measuring the changes in the network thread length, as well as determining the correlation between the threads at different wrist positions. We observed similarities in the kinematic web-network patterns across all specimens, and the interactions between the network threads were aligned to the carpal bones' kinematic behaviour. Furthermore, analyzing the relative changes in the wrist web network has the potential to address the heterogeneity challenges and further facilitate the development of a 3D wrist biomechanics quantitative tool.
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Affiliation(s)
- Ita Suzana Mat Jais
- Department of Biomedical Engineering, National University of Singapore, Singapore.
| | - Yoke-Rung Wong
- Biomechanics Laboratory, Singapore General Hospital, Singapore
| | - Duncan Angus McGrouther
- Biomechanics Laboratory, Singapore General Hospital, Singapore; Department of Hand and Reconstructive Microsurgery, Singapore General Hospital, Singapore
| | - Hwa-Liang Leo
- Department of Biomedical Engineering, National University of Singapore, Singapore
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Trentadue TP, Lopez C, Breighner RE, Akbari-Shandiz M, An KN, Leng S, Holmes DR, Moran SL, Kakar S, Smith J, Thoreson A, Zhao KD. Assessing carpal kinematics following scapholunate interosseous ligament injury ex vivo using four-dimensional dynamic computed tomography. Clin Biomech (Bristol, Avon) 2023; 107:106007. [PMID: 37295340 PMCID: PMC10619963 DOI: 10.1016/j.clinbiomech.2023.106007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 04/28/2023] [Accepted: 05/17/2023] [Indexed: 06/12/2023]
Abstract
BACKGROUND Scapholunate interosseous ligament injuries are prevalent and often challenging to diagnose radiographically. Four-dimensional CT allows visualization of carpal bones during motion. We present a cadaveric model of sequential ligamentous sectionings ("injuries") to quantify their effects on interosseous proximities at the radioscaphoid joint and scapholunate interval. We hypothesized that injury, wrist position, and their interaction affect carpal arthrokinematics. METHODS Eight cadaveric wrists were moved through flexion-extension and radioulnar deviation after injuries. Dynamic CT images of each motion were acquired in each injury condition using a second-generation dual-source CT scanner. Carpal osteokinematics were used to calculate arthrokinematic interosseous proximity distributions during motion. Median interosseous proximities were normalized and categorized by wrist position. Linear mixed-effects models and marginal means tests were used to compare distributions of median interosseous proximities. FINDINGS The effect of wrist position was significant for both flexion-extension and radioulnar deviation at the radioscaphoid joint; the effect of injury was significant for flexion-extension at the scapholunate interval; and the effect of their interaction was significant for radioulnar deviation at the scapholunate interval. Across wrist positions, radioscaphoid median interosseous proximities were less able to distinguish injury conditions versus scapholunate proximities. Median interosseous proximities at the scapholunate interval are majoritively able to detect differences between less (Geissler I-III) versus more (Geissler IV) severe injuries when the wrist is flexed, extended, and ulnarly-deviated. INTERPRETATION Dynamic CT enhances our understanding of carpal arthrokinematics in a cadaveric model of SLIL injury. Scapholunate median interosseous proximities in flexion, extension, and ulnar deviation best demonstrate ligamentous integrity.
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Affiliation(s)
- Taylor P Trentadue
- Assistive and Restorative Technology Laboratory, Rehabilitation Medicine Research Center, Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN, United States of America; Mayo Clinic Medical Scientist Training Program, Mayo Clinic, Rochester, MN, United States of America; Biomedical Engineering and Physiology Graduate Program, Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic, Rochester, MN, United States of America.
| | - Cesar Lopez
- Assistive and Restorative Technology Laboratory, Rehabilitation Medicine Research Center, Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN, United States of America.
| | - Ryan E Breighner
- Department of Radiology and Imaging, Hospital for Special Surgery, New York, NY, United States of America.
| | - Mohsen Akbari-Shandiz
- Assistive and Restorative Technology Laboratory, Rehabilitation Medicine Research Center, Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN, United States of America
| | - Kai-Nan An
- Assistive and Restorative Technology Laboratory, Rehabilitation Medicine Research Center, Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN, United States of America.
| | - Shuai Leng
- Department of Radiology, Mayo Clinic, Rochester, MN, United States of America; Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, United States of America.
| | - David R Holmes
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, United States of America; Biomedical Imaging Resource, Mayo Clinic College of Medicine, Mayo Clinic, Rochester, MN, United States of America.
| | - Steven L Moran
- Department of Orthopedic Surgery, Division of Hand Surgery, Mayo Clinic, Rochester, MN, United States of America.
| | - Sanjeev Kakar
- Department of Orthopedic Surgery, Division of Hand Surgery, Mayo Clinic, Rochester, MN, United States of America; Department of Clinical Anatomy, Mayo Clinic, Rochester, MN, United States of America.
| | - Jay Smith
- Department of Radiology, Mayo Clinic, Rochester, MN, United States of America; Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN, United States of America.
| | - Andrew Thoreson
- Assistive and Restorative Technology Laboratory, Rehabilitation Medicine Research Center, Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN, United States of America.
| | - Kristin D Zhao
- Assistive and Restorative Technology Laboratory, Rehabilitation Medicine Research Center, Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN, United States of America; Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, United States of America; Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN, United States of America.
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3
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Trentadue TP, Lopez C, Breighner RE, Fautsch K, Leng S, Holmes III DR, Moran SL, Thoreson AR, Kakar S, Zhao KD. Evaluation of Scapholunate Injury and Repair with Dynamic (4D) CT: A Preliminary Report of Two Cases. J Wrist Surg 2023; 12:248-260. [PMID: 37223378 PMCID: PMC10202581 DOI: 10.1055/s-0042-1758159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 09/15/2022] [Indexed: 02/11/2023]
Abstract
Background In predynamic or dynamic scapholunate (SL) instability, standard diagnostic imaging may not identify SL interosseous ligament (SLIL) injury, leading to delayed detection and intervention. This study describes the use of four-dimensional computed tomography (4DCT) in identifying early SLIL injury and following injured wrists to 1-year postoperatively. Description of Technique 4DCT acquires a series of three-dimensional volume data with high temporal resolution (66 ms). 4DCT-derived arthrokinematic data can be used as biomarkers of ligament integrity. Patients and Methods This study presents the use of 4DCT in a two-participant case series to assess changes in arthrokinematics following unilateral SLIL injury preoperatively and 1-year postoperatively. Patients were treated with volar ligament repair with volar capsulodesis and arthroscopic dorsal capsulodesis. Arthrokinematics were compared between uninjured, preoperative injured, and postoperative injured (repaired) wrists. Results 4DCT detected changes in interosseous distances during flexion-extension and radioulnar deviation. Generally, radioscaphoid joint distances were greatest in the uninjured wrist during flexion-extension and radioulnar deviation, and SL interval distances were smallest in the uninjured wrist during flexion-extension and radioulnar deviation. Conclusion 4DCT provides insight into carpal arthrokinematics during motion. Distances between the radioscaphoid joint and SL interval can be displayed as proximity maps or as simplified descriptive statistics to facilitate comparisons between wrists and time points. These data offer insight into areas of concern for decreased interosseous distance and increased intercarpal diastasis. This method may allow surgeons to assess whether (1) injury can be visualized during motion, (2) surgery repaired the injury, and (3) surgery restored normal carpal motion. Level of Evidence Level IV, Case series.
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Affiliation(s)
- Taylor P. Trentadue
- Mayo Clinic Medical Scientist Training Program and Mayo Clinic Graduate Program in Biomedical Engineering and Physiology, Assistive and Restorative Technology Laboratory, Mayo Clinic, Rochester, Minnesota
| | - Cesar Lopez
- Assistive and Restorative Technology Laboratory, Mayo Clinic, Rochester, Minnesota
| | - Ryan E. Breighner
- Department of Radiology and Imaging, Hospital for Special Surgery, New York, New York
| | - Kalli Fautsch
- Assistive and Restorative Technology Laboratory, Mayo Clinic, Rochester, Minnesota
| | - Shuai Leng
- Computed Tomography Clinical Innovation Center, Mayo Clinic, Rochester, Minnesota
| | - David R. Holmes III
- Biomedical Imaging Resource Division, Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, Minnesota
| | - Steven L. Moran
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota
| | - Andrew R. Thoreson
- Assistive and Restorative Technology Laboratory, Mayo Clinic, Rochester, Minnesota
| | - Sanjeev Kakar
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota
| | - Kristin D. Zhao
- Assistive and Restorative Technology Laboratory, Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, Minnesota
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Ong JEE, Teng SL, McGrouther DA, Leo HL, Wong YR. A fluid-structure interaction investigation of intra-articular pressure and ligament in wrist joint. Comput Methods Biomech Biomed Engin 2022:1-9. [PMID: 35913092 DOI: 10.1080/10255842.2022.2106133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Understanding the stresses on the scapholunate interosseous ligament (SLIL) and its interaction with synovial fluid pressure could be vital to improve wrist treatment for various wrist conditions such as arthritis, sprains and tendonitis. This study investigated the interaction between the intra-articular pressure, specifically the synovial fluid pressure change and the SLIL stresses in a computational model during wrist radioulnar deviation (RUD). Magnetic resonance imaging (MRI) scans were used to acquire the anatomical model of the carpal bones and ligament, while the kinematics of scaphoid and lunate were obtained through dynamic computerized tomography (CT) scans. A two-way fluid-structure interaction (FSI) was used to model the dynamics between the scaphoid and lunate, the SLIL, and the synovial fluid. The synovial fluid pressure change was found to be small (-4.86 to 3.23 Pa) and close to that simulated in a previous work without the SLIL (-1.68 to 2.64 Pa). Furthermore, peaks of maximum fluid pressure were found to trail the peaks of ligament stress. Therefore, it is suggested that the influence of synovial fluid pressure on the ligament in the SLIL model is negligible and simulations of the scapholunate joint could forego fluid-structure interactions. Future studies can instead explore other structures in the carpus that can possibly contribute to the ligament stresses. Clinically, treatments can be targeted at these areas to help prevent or slow the progression of ligament injuries into serious consequences like the degenerative joint disease.
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Affiliation(s)
- Joachim Ee En Ong
- Department of Mechanical Engineering, National University of Singapore, Singapore
| | - Shi Lei Teng
- Biomechanics Laboratory, Singapore General Hospital, Singapore
| | - Duncan Angus McGrouther
- Biomechanics Laboratory, Singapore General Hospital, Singapore.,Department of Hand and Reconstructive MicroSurgery, Singapore General Hospital, Singapore
| | - Hwa Liang Leo
- Department of Biomedical Engineering, National University of Singapore, Singapore
| | - Yoke Rung Wong
- Biomechanics Laboratory, Singapore General Hospital, Singapore
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Brinkhorst M, Foumani M, van Rosmalen J, Selles R, Hovius S, Strackee S, Streekstra G. Quantifying in vivo scaphoid, lunate, and capitate kinematics using four-dimensional computed tomography. Skeletal Radiol 2021; 50:351-359. [PMID: 32734373 PMCID: PMC7736028 DOI: 10.1007/s00256-020-03543-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 07/04/2020] [Accepted: 07/06/2020] [Indexed: 02/02/2023]
Abstract
OBJECTIVE We aimed to establish a quantitative description of motion patterns and establish test-retest reliability of the four-dimensional CT when quantifying in vivo kinematics of the scaphoid, lunate, and capitate. MATERIALS AND METHODS We assessed in vivo kinematics of both wrists of 20 healthy volunteers (11 men and 9 women) between the ages of 20 and 40 years. All volunteers performed active flexion-extension and radial-ulnar deviation with both wrists. To test for reliability, one motion cycle was rescanned for both wrists approximately 15 min after the first scan. The coefficient of multiple correlation was used to analyze reliability. When two motion patterns are similar, the coefficient of multiple correlation tends towards 1, whereas in dissimilar motion patterns, it tends towards 0. The root mean square deviation was used to analyze the total motion patterns variability between the two scans. RESULTS Overall, mean or median coefficient of multiple correlations were higher than 0.86. The root mean square deviations were low and ranged from 1.17° to 4.29°. CONCLUSION This innovative non-invasive imaging technique can reliably describe in vivo carpal kinematics of uninjured wrists in healthy individuals. It provides us with a better understanding and reference values of carpal kinematics of the scaphoid, lunate, and capitate.
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Affiliation(s)
- Michelle Brinkhorst
- grid.5645.2000000040459992XDepartment of Plastic, Reconstructive and Hand Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Mahyar Foumani
- grid.416468.90000 0004 0631 9063Department of Plastic, Reconstructive and Hand Surgery, Martini Hospital, Groningen, the Netherlands
| | - Joost van Rosmalen
- grid.5645.2000000040459992XDepartment of Biostatistics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Ruud Selles
- grid.5645.2000000040459992XDepartment of Plastic, Reconstructive and Hand Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands ,grid.5645.2000000040459992XDepartment of Rehabilitation Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Steven Hovius
- Xpert Clinic, Hand and Wrist Clinic, Amsterdam, the Netherlands ,grid.10417.330000 0004 0444 9382Department of Plastic, Reconstructive and Hand Surgery, Radboudumc, Nijmegen, the Netherlands
| | - Simon Strackee
- grid.7177.60000000084992262Department of Plastic, Reconstructive and Hand Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Geert Streekstra
- grid.7177.60000000084992262Department of Biomedical Engineering and Physics, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands ,grid.7177.60000000084992262Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
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6
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Henrichon SS, Foster BH, Shaw C, Bayne CO, Szabo RM, Chaudhari AJ, Boutin RD. Dynamic MRI of the wrist in less than 20 seconds: normal midcarpal motion and reader reliability. Skeletal Radiol 2020; 49:241-248. [PMID: 31289900 PMCID: PMC6934906 DOI: 10.1007/s00256-019-03266-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 06/13/2019] [Accepted: 06/17/2019] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To describe the normal motion pattern at the midcarpal compartment during active radial-ulnar deviation of the wrist using dynamic MRI, and to determine the observer performance for measurements obtained in asymptomatic volunteers. METHODS Dynamic MRI of 35 wrists in 19 asymptomatic volunteers (age mean 30.4 years, SD 8.6) was performed during active radial-ulnar deviation using a fast gradient-echo pulse sequence with 315 ms temporal resolution (acquisition time, 19 s). Two independent readers measured the transverse translation of the trapezium at the scaphotrapezium joint (STJ) and the capitate-to-triquetrum distance (CTD). Relationships between these measurements and laterality, sex, lunate type, and wrist kinematic pattern were evaluated. RESULTS At the STJ, the trapezium moved most in radial deviation, with an overall translation of 2.3 mm between ulnar and radial deviation. Mean CTD measurements were the greatest in ulnar deviation and varied 2.4 mm between ulnar and radial deviation. Mean CTD was greater in men than women in the neutral position (p = 0.019), and in wrists with type II lunate morphology during radial and ulnar deviation (p = 0.001, p = 0.014). There were no significant differences in trapezium translation or CTD with wrist laterality and kinematic pattern. Intraobserver and interobserver correlation coefficients were 0.97 and 0.87 for trapezium translation and 0.84 and 0.67 for CTD. CONCLUSION This study is the first to demonstrate the performance of dynamic MRI to quantify STJ motion and CTD. Dynamic MRI with a short acquisition time may be used as a tool to supplement static MRI in evaluation of the midcarpal compartment.
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Affiliation(s)
| | | | - Calvin Shaw
- Department of Radiology, University of California - Davis, Sacramento, CA 95817
| | - Christopher O. Bayne
- Department of Orthopaedic Surgery, University of California - Davis, Sacramento, CA 95817
| | - Robert M. Szabo
- Department of Orthopaedic Surgery, University of California - Davis, Sacramento, CA 95817
| | | | - Robert D. Boutin
- Department of Radiology, University of California - Davis, Sacramento, CA 95817
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7
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Dobbe JGG, de Roo MGA, Visschers JC, Strackee SD, Streekstra GJ. Evaluation of a Quantitative Method for Carpal Motion Analysis Using Clinical 3-D and 4-D CT Protocols. IEEE TRANSACTIONS ON MEDICAL IMAGING 2019; 38:1048-1057. [PMID: 30369440 DOI: 10.1109/tmi.2018.2877503] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
For wrist complaints related to motion, a 2-D radiograph or CT scan of the static wrist may not always be considered diagnostic. 3-D motion imaging, i.e., multiple 3DCT scans in time (4DCT), enables quantifying carpal motion and comparing motion patterns of the affected wrist with those of the healthy contralateral side. The accuracy and precision of the method, however, is limited by noise and motion artifacts. Although, the technique is considered promising in existing literature, the accuracy and precision of carpal motion analysis has never been investigated systematically. In this paper, we introduce and evaluate a semi-automatic segmentation- and registration-based method for 3-D carpal motion analysis. We investigate the accuracy and precision of the method, and its dependency on motion and scan parameters (angular velocity, dose, gantry revolution angle for image reconstruction, and scanner type) using a wrist phantom. During standstill the positioning error was ≤ 0.23 mm and ≤ 0.78°. A partial gantry revolution for 3-D reconstruction introduced image deformation, contributing to a positioning error of approx. 0.8 mm. This error increased with reduced dose, and with increasing angular velocity of the wrist phantom. In cases where the phantom was rotating about an axis parallel to the rotation axis of the gantry, and in a direction opposite to the gantry, the positioning error increased, probably because of the apparent increase in angular velocity with respect to the gantry. Slow carpal motion 4DCT analysis is feasible using a regular CT scanner. A partial gantry revolution angle for 3-D reconstruction may introduce image deformation, which decreases the accuracy of carpal motion analysis. Knowing the positioning error in 4DCT imaging with the proposed method is considered valuable when investigating wrist injury since it enables discrimination of actual motion from apparent motion caused by methodological error.
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8
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Foster BH, Shaw CB, Boutin RD, Joshi AA, Bayne CO, Szabo RM, Chaudhari AJ. A principal component analysis-based framework for statistical modeling of bone displacement during wrist maneuvers. J Biomech 2019; 85:173-181. [PMID: 30738587 DOI: 10.1016/j.jbiomech.2019.01.030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 01/13/2019] [Accepted: 01/16/2019] [Indexed: 01/06/2023]
Abstract
We present a method for the statistical modeling of the displacements of wrist bones during the performance of coordinated maneuvers, such as radial-ulnar deviation (RUD). In our approach, we decompose bone displacement via a set of basis functions, identified via principal component analysis (PCA). We utilized MRI wrist scans acquired at multiple static positions for deriving these basis functions. We then utilized these basis functions to compare the displacements undergone by the bones of the left versus right wrist in the same individual, and between bones of the wrists of men and women, during the performance of the coordinated RUD maneuver. Our results show that the complex displacements of the wrist bones during RUD can be modeled with high reliability with just 5 basis functions, that captured over 91% of variation across individuals. The basis functions were able to predict intermediate wrist bone poses with an overall high accuracy (mean error of 0.26 mm). Our proposed approach found statistically significant differences between bone displacement trajectories in women versus men, however, did not find significant differences in those of the left versus right wrist in the same individual. Our proposed method has the potential to enable detailed analysis of wrist kinematics for each sex, and provide a robust framework for characterizing the normal and pathologic displacement of the wrist bones, such as in the context of wrist instability.
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Affiliation(s)
- Brent H Foster
- Department of Biomedical Engineering, University of California Davis, Davis, CA 95616, USA
| | - Calvin B Shaw
- Department of Radiology, University of California Davis School of Medicine, Sacramento, CA 95817, USA
| | - Robert D Boutin
- Department of Radiology, University of California Davis School of Medicine, Sacramento, CA 95817, USA
| | - Anand A Joshi
- Signal and Image Processing Institute, University of Southern California, Los Angeles, CA 90089, USA
| | - Christopher O Bayne
- Department of Orthopedic Surgery, University of California Davis School of Medicine, Sacramento, CA 95817, USA
| | - Robert M Szabo
- Department of Orthopedic Surgery, University of California Davis School of Medicine, Sacramento, CA 95817, USA
| | - Abhijit J Chaudhari
- Department of Radiology, University of California Davis School of Medicine, Sacramento, CA 95817, USA.
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Buzzatti L, Keelson B, Apperloo J, Scheerlinck T, Baeyens JP, Van Gompel G, Vandemeulebroucke J, de Maeseneer M, de Mey J, Buls N, Cattrysse E. Four-dimensional CT as a valid approach to detect and quantify kinematic changes after selective ankle ligament sectioning. Sci Rep 2019; 9:1291. [PMID: 30718794 PMCID: PMC6361967 DOI: 10.1038/s41598-018-38101-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Accepted: 12/11/2018] [Indexed: 01/30/2023] Open
Abstract
The objective of the current study was to explore the potential of dynamic computed tomography to detect kinematic changes, induced by sequential sectioning of the lateral collateral ligaments of the ankle, during full motion sequence of the talocrural joint. A custom-made device was used to induce cyclic controlled ankle inversion movement in one fresh frozen cadaver leg. A 256-slice CT scanner was used to investigate four different scenarios. Scenario 1 with all ligaments intact was first investigated followed by sequential section of the anterior talo-fibular ligament (Scenario 2), the calcaneo-fibular ligament (Scenario 3) and posterior talo-fibular ligament (Scenario 4). Off-line image processing based on semi-automatic segmentation and bone rigid registration was performed. Motion parameters such as translation, rotational angles and orientation and position of the axis of rotation were calculated. Differences between scenarios were calculated. Progressive increase of cranio-caudal displacement up to 3.9 mm and flexion up to 10° compared to Scenario 1 were reported. Progressive changes in orientation (up to 20.6°) and position (up to 4.1 mm) of the axis of rotation were also shown. Estimated effective dose of 0.005 mSv (1.9 mGy CTDIvol) was reported. This study demonstrated that kinematic changes due to the absence of ligament integrity can be detected with 4DCT with minimal radiation exposure. Identifying abnormal kinematic patterns could have future application in helping clinicians to choose patients’ optimal treatment. Therefore, further studies with bigger in vitro sample sizes and consequent investigations in vivo are recommended to confirm the current findings.
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Affiliation(s)
- Luca Buzzatti
- Department of Physiotherapy, Human Physiology and Anatomy (KIMA), Vrije Universiteit Brussel, Brussel, Belgium.
| | - Benyameen Keelson
- Department of Radiology, Universitair Ziekenhuis Brussel, Brussel, Belgium.,Department of Electronics and Informatics (ETRO), Vrije Universiteit Brussel, Brussel, Belgium.,Imec, Leuven, Belgium
| | - Jildert Apperloo
- Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussel, Belgium
| | - Thierry Scheerlinck
- Department of Orthopaedic Surgery and Traumatology, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussel, Belgium
| | - Jean-Pierre Baeyens
- Department of Movement and Sport Sciences, Vrije Universiteit Brussel, Brussel, Belgium.,University College of Physiotherapy THIM, Landquart, Switzerland
| | - Gert Van Gompel
- Department of Radiology, Universitair Ziekenhuis Brussel, Brussel, Belgium
| | - Jef Vandemeulebroucke
- Department of Electronics and Informatics (ETRO), Vrije Universiteit Brussel, Brussel, Belgium.,Imec, Leuven, Belgium
| | | | - Johan de Mey
- Department of Radiology, Universitair Ziekenhuis Brussel, Brussel, Belgium
| | - Nico Buls
- Department of Radiology, Universitair Ziekenhuis Brussel, Brussel, Belgium
| | - Erik Cattrysse
- Department of Physiotherapy, Human Physiology and Anatomy (KIMA), Vrije Universiteit Brussel, Brussel, Belgium
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The Effect of Dorsally Angulated Distal Radius Deformities on Carpal Kinematics: An In Vitro Biomechanical Study. J Hand Surg Am 2018; 43:1036.e1-1036.e8. [PMID: 29573895 DOI: 10.1016/j.jhsa.2018.02.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Revised: 01/11/2018] [Accepted: 02/13/2018] [Indexed: 02/02/2023]
Abstract
PURPOSE The purpose was to quantify the effect of distal radius dorsal angulation (DA) on carpal kinematics and the relative roles of the radiocarpal and midcarpal joints during wrist motion. METHODS Six cadaveric specimens (69 ± 17 y) were mounted at 90° elbow flexion in a custom wrist motion simulator. The wrist was guided through planar passive flexion and extension motion trials (∼ 5°/s). A custom modular distal radius implant was used to simulate native alignment and 3 distal radius DA deformities (10°, 20°, 30°). An optical tracking system captured carpal bone motion, from which radiocarpal and midcarpal joint motion was determined. RESULTS The radiocarpal joint made a greater contribution to wrist motion than the midcarpal joint in flexion, and the midcarpal joint made a greater contribution to motion than the radiocarpal joint in wrist extension. Increasing DA caused the radiocarpal joint contribution to increase throughout the motion arc, with the effect being more pronounced in wrist flexion. Conversely, as DA increased, the midcarpal joint contributed less rotation to the total wrist motion and its overall motion arc decreased; the magnitude of effect was greater in wrist extension. Dorsal angulation resulted in increased lunate flexion with respect to the distal radius. CONCLUSIONS Our findings agree with current literature that suggests that, in an uninjured wrist, the radiocarpal joint predominates flexion, and the midcarpal joint predominates extension. In addition, the radiocarpal joint has an amplified contribution in wrist flexion with greater DA malunion. CLINICAL RELEVANCE The altered contributions of the radiocarpal and midcarpal joints may contribute to pain, stiffness, and the development of arthritis, which is commonly seen at the radiocarpal joint after malunion of the distal radius.
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Abou Arab W, Rauch A, Chawki MB, Dap F, Dautel G, Blum A, Gondim Teixeira PA. Scapholunate instability: improved detection with semi-automated kinematic CT analysis during stress maneuvers. Eur Radiol 2018; 28:4397-4406. [PMID: 29713765 DOI: 10.1007/s00330-018-5430-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Revised: 03/04/2018] [Accepted: 03/16/2018] [Indexed: 02/07/2023]
Abstract
OBJECTIVES To evaluate the diagnostic performance of radioulnar deviation (RUD) and clenching fist (CF) maneuvers for the evaluation of scapholunate dissociation (SLD) using quantitative kinematic CT. METHODS Thirty-seven patients with suspected scapholunate instability were prospectively evaluated with kinematic CT. Two radiologists independently evaluated the SLD during RUD and CF maneuvers. Various dynamic parameters describing SLD were compared (maximal value, variation coefficient and range) in patients with and without scapholunate ligament ruptures confirmed by CT arthrography. RESULTS SLD in CF varied from 3.17 ± 0.38 to 3.24 ± 0.80 mm in controls and from 4.11 ± 0.77 and 4.01 ± 0.85 mm in patients with scapholunate ligament ruptures for reader 1 and 2 (p < 0.009). SLD in RUD varied from 3.35 ± 0.51 and 3.01 ± 0.78 mm in controls and from 4.51 ± 1.26 to 4.42 ± 1.75 mm in patients with scapholunate ligament ruptures for reader 1 and 2 (p varied from 0.001 to 0.002). The inter-observer variability was better for RUD (ICC = 0.85 versus 0.6 for RUD and CF respectively). CONCLUSION Analysis of SLD using kinematic CT has shown significant measurement differences between the groups with or without scapholunate instability with good diagnostic performance. KEY POINTS • Kinematic CT can quantitatively assess scapholunate dissociation. • SLD analysis on kinematic CT has excellent reproducibility with radioulnar deviation maneuver. • Scapholunate dissociation was significantly different in patients with and without instability. • Diagnostic performance for scapholunate instability identification was better with radioulnar deviation.
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Affiliation(s)
- Waled Abou Arab
- Guilloz Imaging Department, Central Hospital, University Hospital Center of Nancy, 29 avenue du Maréchal de Lattre de Tassigny, 54035, Nancy cedex, France.
| | - Aymeric Rauch
- Guilloz Imaging Department, Central Hospital, University Hospital Center of Nancy, 29 avenue du Maréchal de Lattre de Tassigny, 54035, Nancy cedex, France
| | - Mohammad B Chawki
- Nuclear Medecine Department, Central Hospital, University Hospital Center of Nancy, 29 avenue du Maréchal de Lattre de Tassigny, 54035, Nancy cedex, France
| | | | | | - Alain Blum
- Lorraine University, IADI laboratory, UMR S 947, rue du Morvan, 54511, Vandoeuvre-lès-Nancy, France
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