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Zou D, Hu X, An KN, Dai K, Yu X, Gong W, Tsai TY. Distal Humeral Trochlear Geometry Associated With the Spatial Variation of the Dynamic Elbow Flexion Axis. Front Bioeng Biotechnol 2022; 10:850198. [PMID: 35814006 PMCID: PMC9263270 DOI: 10.3389/fbioe.2022.850198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 05/13/2022] [Indexed: 11/24/2022] Open
Abstract
Background: The complexity of the spatial dynamic flexion axis (DFA) of the elbow joint makes the elbow prosthesis design and humeral component alignment challenging. This study aimed to 1) investigate the variations of the spatial DFA during elbow flexion and 2) investigate the relationship between the distal humeral trochlear geometry and the in vivo spatial variation of the DFA. Methods: Ten healthy subjects participated in this study. Each subject performed a full elbow extension to maximum flexion with hand supination under dual fluoroscopic imaging system (DFIS) surveillance. The 2D fluoroscopic images and the 3D bone models were registered to analyze the in vivo elbow kinematics and DFAs. The spatial DFA positions were defined as inclination with the medial and lateral epicondyle axes (MLA) in the transverse and coronal planes. The range of the DFA positions was also investigated during different flexion phases. The Spearman correlation method was used to analyze the relationship between the distal humeral trochlear’s morphological parameters and the position of DFAs during different flexion phases. Results: The pathway of the DFAs showed an irregular pattern and presented individual features. The medial trochlear depth (MTD) (r = 0.68, p = 0.03) was positively correlated with the range of the DFA position (2.8° ± 1.9°) in the coronal plane from full extension to 30° of flexion. Lateral trochlear height (LTH) (r = −0.64, p = 0.04) was negatively correlated with the DFA position (−1.4° ± 3.3°) in the transverse plane from 30° to 60° of flexion. A significant correlation was found between LTH with the DFA position in the coronal (r = −0.77, p = 0.01) and transverse planes (r = −0.76, p = 0.01) from 60° to 90° of flexion. Conclusion: This study showed that the pathway of the dynamic flexion axis has an individual pattern. The medial and lateral trochlear sizes were the key parameters that might affect the elbow joint flexion function. When recovering complex distal humeral fractures or considering the implant design of total elbow arthroplasty, surgeons should pay more attention to the medial and lateral trochlea’s geometry, which may help restore normal elbow kinematics.
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Affiliation(s)
- Diyang Zou
- School of Biomedical Engineering & Med-X Research Institute, Shanghai Jiao Tong University, Shanghai, China
- Engineering Research Center of Digital Medicine and Clinical Translation, Ministry of Education, Shanghai, China
| | - Xiangjun Hu
- Department of Rehabilitation Medicine, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Kai-Nan An
- Department of Biomechanics, Mayo Clinic, Rochester, MN, United States
| | - Kerong Dai
- School of Biomedical Engineering & Med-X Research Institute, Shanghai Jiao Tong University, Shanghai, China
- Department of Orthopaedic Surgery, Shanghai Ninth People s Hospital, Shanghai Key Laboratory of Orthopaedic Implants & Clinical Translation R&D Center of 3D Printing Technology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Engineering Research Center of Digital Medicine and Clinical Translation, Ministry of Education, Shanghai, China
| | - Xiaowei Yu
- Department of Orthopaedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
| | - Weihua Gong
- Department of Orthopaedic Surgery, Shanghai Ninth People s Hospital, Shanghai Key Laboratory of Orthopaedic Implants & Clinical Translation R&D Center of 3D Printing Technology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- *Correspondence: Weihua Gong, ; Tsung-Yuan Tsai,
| | - Tsung-Yuan Tsai
- School of Biomedical Engineering & Med-X Research Institute, Shanghai Jiao Tong University, Shanghai, China
- Department of Orthopaedic Surgery, Shanghai Ninth People s Hospital, Shanghai Key Laboratory of Orthopaedic Implants & Clinical Translation R&D Center of 3D Printing Technology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Engineering Research Center of Digital Medicine and Clinical Translation, Ministry of Education, Shanghai, China
- *Correspondence: Weihua Gong, ; Tsung-Yuan Tsai,
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Van Hauwermeiren L, Verstraete M, Stouthandel MEJ, Van Oevelen A, De Gersem W, Delrue L, Achten E, Adriaens D, Van Hoof T. Joint coordinate system for biomechanical analysis of the sacroiliac joint. J Orthop Res 2019; 37:1101-1109. [PMID: 30839121 DOI: 10.1002/jor.24271] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2018] [Accepted: 02/17/2019] [Indexed: 02/04/2023]
Abstract
Sacroiliac joint (SIJ) biomechanics have been described in both in vitro and in vivo studies. A standard for joint coordinate systems has been created by the International Society of Biomechanics for most of the joints in the human body. However, a standardized joint coordinate system for sacroiliac joint motion analysis is currently still lacking. This impedes the comparison across studies and hinders communication among scientists and clinicians. As SIJ motion is reported to be quite limited, a proper standardization and reproducibility of this procedure is essential for the interpretation of future biomechanical SIJ studies. This paper proposes a joint coordinate system for the analysis of sacroiliac joint motion, based on the procedure developed by Grood and Suntay, using semi-automated anatomical landmarks on 3D joint surfaces. This coordinate system offers high inter-rater reliability and aspires to a more intuitive representation of biomechanical data, as it is aligned with SIJ articular surfaces. This study aims to encourage further reflection and debate on biomechanical data representation, in order to facilitate interpretation of SIJ biomechanics and improve communication between researchers and clinicians. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res.
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Affiliation(s)
| | - Matthias Verstraete
- Department of Physical Medicine and Orthopedic Surgery, Ghent University, Ghent, Belgium
| | - Michael E J Stouthandel
- Department of Radiation Oncology and Experimental Cancer Research, Ghent University, Ghent, Belgium
| | - Aline Van Oevelen
- Department of Anatomy and Embryology, Ghent University, Ghent, Belgium
| | - Werner De Gersem
- Department of Radiation Oncology and Experimental Cancer Research, Ghent University, Ghent, Belgium
| | - Louke Delrue
- Department of Radiology and Nuclear Medicine, Ghent University Hospital, Ghent, Belgium
| | - Eric Achten
- Department of Radiology and Nuclear Medicine, Ghent University Hospital, Ghent, Belgium
| | - Dominique Adriaens
- Department of Biology (Evolutionary Morphology of Vertebrates), Ghent University, Ghent, Belgium
| | - Tom Van Hoof
- Department of Radiation Oncology and Experimental Cancer Research, Ghent University, Ghent, Belgium
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Hiro ME, Schiffman CJ, Muriuki MG, Havey RM, Voronov LI, Bindra RR. Biomechanics of an Articulated Screw in Acute Scapholunate Ligament Disruption. J Wrist Surg 2018; 7:101-108. [PMID: 29576914 PMCID: PMC5864488 DOI: 10.1055/s-0037-1608637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Accepted: 09/30/2017] [Indexed: 10/18/2022]
Abstract
Background An injury to the scapholunate interosseous ligament (SLIL) leads to instability in the scapholunate joint. Temporary fixation is used to protect the ligament during reconstruction or healing of the repair. Rigid screw fixation-by blocking relative physiological motion between the scaphoid and lunate-can lead to screw loosening, pullout, and fracture. Purpose This study aims to evaluate changes in scaphoid and lunate kinematics following SLIL injury and the effectiveness of an articulating screw at restoring preinjury motion. Materials and Methods The kinematics of the scaphoid and lunate were measured in 10 cadaver wrists through three motions driven by a motion simulator. The specimens were tested intact, immediately following SLIL injury, after subsequent cycling, and after fixation with a screw. Results Significant changes in scaphoid and lunate motion occurred following SLIL injury. Postinjury cycling increased motion changes in flexion-extension and radial-ulnar deviation. The motion was not significantly different from the intact scapholunate joint after placement of the articulating screw. Conclusion In agreement with other studies, sectioning of the SLIL led to significant kinematic changes of the scaphoid and lunate in all motions tested. Compared with intact scapholunate joint, no significant difference in kinematics was found after placement of the screw indicating a correction of some of the changes produced by SLIL transection. These findings suggest that the articulating screw may be effective for protecting a SLIL repair while allowing the physiological rotation to occur between the scaphoid and lunate. Clinical Relevance A less rigid construct, such as the articulating screw, may allow earlier wrist rehabilitation with less screw pullout or failure.
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Affiliation(s)
- Matthew E. Hiro
- Division of Plastic Surgery, Bay Pines VA Medical Center, Bay Pines, Florida
| | - Corey J. Schiffman
- Stritch School of Medicine, Loyola University Chicago, Maywood, Illinois
| | - Muturi G. Muriuki
- Musculoskeletal Biomechanics Research Lab, Edward Hines Jr. VA Hospital, Hines, Illinois
| | - Robert M. Havey
- Musculoskeletal Biomechanics Research Lab, Edward Hines Jr. VA Hospital, Hines, Illinois
| | - Leonard I. Voronov
- Musculoskeletal Biomechanics Research Lab, Edward Hines Jr. VA Hospital, Hines, Illinois
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