1
|
Postolka B, Killen BA, Boey H, Malaquias TM, Natsakis T, Clockaerts S, Misselyn D, Coudyzer W, Vander Sloten J, Jonkers I. Hindfoot kinematics and kinetics - A combined in vivo and in silico analysis approach. Gait Posture 2024; 112:8-15. [PMID: 38723393 DOI: 10.1016/j.gaitpost.2024.04.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 03/13/2024] [Accepted: 04/23/2024] [Indexed: 06/23/2024]
Abstract
BACKGROUND The complex anatomical structure of the foot-ankle imposes challenges to accurately quantify detailed hindfoot kinematics and estimate musculoskeletal loading parameters. Most systems used to capture or estimate dynamic joint function oversimplify the anatomical structure by reducing its complexity. RESEARCH QUESTION Can four dimensional computed tomography (4D CT) imaging in combination with an innovative foot manipulator capture in vivo hindfoot kinematics during a simulated stance phase of walking and can talocrural and subtalar articular joint mechanics be estimated based on a detailed in silico musculoskeletal foot-ankle model. METHODS A foot manipulator imposed plantar/dorsiflexion and inversion/eversion representing a healthy stance phase of gait in 12 healthy participants while simultaneously acquiring 4D CT images. Participant-specific 3D hindfoot rotations and translations were calculated based on bone-specific anatomical coordinate systems. Articular cartilage contact area and contact pressure of the talocrural and subtalar joints were estimated using an extended foot-ankle model updated with an elastic foundation contact model upon prescribing the participant-specific rotations measured in the 4D CT measurement. RESULTS Plantar/dorsiflexion predominantly occurred at the talocrural joint (RoM 15.9±3.9°), while inversion/eversion (RoM 5.9±3.9°) occurred mostly at the subtalar joint, with the contact area being larger at the subtalar than at the talocrural joint. Contact pressure was evenly distributed between the talocrural and subtalar joint at the beginning of the simulated stance phase but was then redistributed from the talocrural to the subtalar joint with increasing dorsiflexion. SIGNIFICANCE In a clinical case study, the healthy participants were compared with four patients after surgically treaded intra-articular calcaneal fracture. The proposed workflow was able to detect small but meaningful differences in hindfoot kinematics and kinetics, indicative of remaining hindfoot pathomechanics that may influence the onset and progression of degenerative joint diseases.
Collapse
Affiliation(s)
- Barbara Postolka
- KU Leuven, Department of Movement Sciences, Human Movement Biomechanics Research Group, Tervuursevest 101, Leuven 3001, Belgium.
| | - Bryce A Killen
- KU Leuven, Department of Movement Sciences, Human Movement Biomechanics Research Group, Tervuursevest 101, Leuven 3001, Belgium
| | - Hannelore Boey
- KU Leuven, Department of Movement Sciences, Human Movement Biomechanics Research Group, Tervuursevest 101, Leuven 3001, Belgium; KU Leuven, Department of Mechanical Engineering, Biomechanics Section, Celestijnenlaan 300C, Leuven 3001, Belgium
| | - Tiago M Malaquias
- KU Leuven, Department of Mechanical Engineering, Biomechanics Section, Celestijnenlaan 300C, Leuven 3001, Belgium
| | - Tassos Natsakis
- KU Leuven, Department of Mechanical Engineering, Biomechanics Section, Celestijnenlaan 300C, Leuven 3001, Belgium; Technical University of Cluj-Napoca, Department of Automation, Dorobantilor 71-73, Cluj-Napoca 400268, Romania
| | - Stefan Clockaerts
- Holy Heart Hospital Lier, Department of Orthopaedic Surgery and Traumatology, Mechelsesteenweg 24, Lier 2500, Belgium
| | - Dominique Misselyn
- UZ Leuven, Department of Development and Regeneration, Herestraat 49, Leuven 3000, Belgium
| | | | - Jos Vander Sloten
- KU Leuven, Department of Mechanical Engineering, Biomechanics Section, Celestijnenlaan 300C, Leuven 3001, Belgium
| | - Ilse Jonkers
- KU Leuven, Department of Movement Sciences, Human Movement Biomechanics Research Group, Tervuursevest 101, Leuven 3001, Belgium
| |
Collapse
|
2
|
Mazza DF, Boonsri PS, Arora A, Bayne CO, Szabo RM, Chaudhari AJ, Boutin RD. Relationships between diagnostic imaging of first carpometacarpal osteoarthritis and pain, functional status, and disease progression: A systematic review. Osteoarthritis Cartilage 2024; 32:476-492. [PMID: 38141842 DOI: 10.1016/j.joca.2023.11.023] [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: 12/22/2022] [Revised: 10/20/2023] [Accepted: 11/29/2023] [Indexed: 12/25/2023]
Abstract
OBJECTIVE To systematically review the association of pain, function, and progression in first carpometacarpal (CMC) osteoarthritis (OA) with imaging biomarkers and radiography-based staging. DESIGN Database searches in PubMed, Embase, and the Cochrane Library, along with citation searching were conducted in accordance with published guidance. Data on the association of imaging with pain, functional status, and disease progression were extracted and synthesized, along with key information on study methodology such as sample sizes, use of control subjects, study design, number of image raters, and blinding. Methodological quality was assessed using National Heart, Lung, and Blood Institute tools. RESULTS After duplicate removal, a total of 1969 records were screened. Forty-six articles are included in this review, covering a total of 28,202 study participants, 7263 with first CMC OA. Osteophytes were found to be one of the strongest biomarkers for pain across imaging modalities. Radiographic findings alone showed conflicting relationships with pain. However, Kellgren-Lawrence staging showed consistent associations with pain in various studies. Radiographic, sonographic, and MRI findings and staging showed little association to tools evaluating functional status across imaging modalities. The same imaging methods showed limited ability to predict progression of first CMC OA. A major limitation was the heterogeneity in the study base, limiting synthesis of results. CONCLUSION Imaging findings and radiography-based staging systems generally showed strong associations with pain, but not with functional status or disease progression. More research and improved imaging techniques are needed to help physicians better manage patients with first CMC OA.
Collapse
Affiliation(s)
- Dario F Mazza
- Department of Radiology, University of California, Davis, CA, USA.
| | | | - Aman Arora
- Department of Radiology, University of California, Davis, CA, USA.
| | - Christopher O Bayne
- Department of Orthopaedic Surgery, University of California, Davis, CA, USA.
| | - Robert M Szabo
- Department of Orthopaedic Surgery, University of California, Davis, CA, USA.
| | | | - Robert D Boutin
- Department of Radiology, Stanford University School of Medicine, Stanford, CA, USA.
| |
Collapse
|
3
|
Yu J, Luo L, Zhu W, Li Y, Xie P, Zhang L. A Novel Low-Pressure Robotic Glove Based on CT-Optimized Finger Joint Kinematic Model for Long-Term Rehabilitation of Stroke Patients. IEEE Trans Neural Syst Rehabil Eng 2024; 32:53-62. [PMID: 38032787 DOI: 10.1109/tnsre.2023.3337827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2023]
Abstract
Wearing robotic gloves has become increasingly crucial for hand rehabilitation in stroke patients. However, traditional robotic gloves can exert additional pressure on the hand, such as prolonged use leading to poor blood circulation and muscle stiffness. To address these concerns, this work analyzes the finger kinematic model based on computerized tomography (CT) images of human hands, and designs a low-pressure robotic glove that conforms to finger kinematic characteristics. Firstly, physiological data on finger joint flexion and extension were collected through CT scans. The equivalent rotation centers of finger joints were obtained using the SURF and RANSAC algorithms. Furthermore, the trajectory of finger joint end and the correlation equation of finger joint motion were fitted, and a comprehensive finger kinematic model was established. Based on this finger kinematic model, a novel under-actuated exoskeleton mechanism was designed using a human-machine integration approach. The novel robotic glove fully aligns with the equivalent rotation centers and natural motion trajectories of the fingers, exerting minimal and evenly distributed dynamic pressure on the fingers, with a theoretical static pressure value of zero. Experiments involving gripping everyday objects demonstrated that the novel robotic glove significantly reduces the overall pressure on the fingers during grasping compared to the pneumatic glove and the traditional exoskeleton robotic glove. It is suitable for long-term use by stroke patients for rehabilitation training.
Collapse
|
4
|
Schulze N, Werpy N, Gernhardt J, Fritsch G, Hildebrandt T, Vanderperren K, Klopfleisch R, Ben Romdhane R, Lischer C, Ehrle A. Dynamic three-dimensional computed tomographic imaging facilitates evaluation of the equine cervical articular process joint in motion. Equine Vet J 2023; 55:83-91. [PMID: 35043993 DOI: 10.1111/evj.13560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 11/08/2021] [Accepted: 12/30/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND Dynamic computed tomography (CT) imaging has been introduced in human orthopaedics and is continuing to gain popularity. With dynamic CT, video sequences of anatomical structures can be evaluated in motion. OBJECTIVES To investigate the feasibility of dynamic CT for diagnostic imaging of the equine cervical articular process joints (APJs) and to give a detailed description of the APJ movement pattern. STUDY DESIGN Descriptive cadaver imaging. METHODS Cervical specimens of twelve Warmblood horses were included. A custom-made motorised testing device was used to position and manipulate the neck specimens and perform dynamic 2D and 3D CT imaging. Images were obtained with a 320-detector-row CT scanner with a 160 mm wide-area (2D) solid-state detector design that allows image acquisition of a volumetric axial length of 160 mm without moving the CT couch. Dynamic videos were acquired and divided into four phases of movement. Three blinded observers used a subjective scale of 1 (excellent) to 4 (poor) to grade the overall image quality in each phases of motion cycle. RESULTS With an overall median score of 1 the image quality, a significantly lower score was observed in the dynamic 3D videos over the four phases by the three observers compared with the 2D videos for both flexion (3D 95% CI: 1-2 and 2D 95% CI: 1-3; P = .007) and extension movement (3D 95% CI: 1-2 and 2D 95% CI: 1-3; P = .008). Median Translational displacement of the APJ surface was significantly greater in flexion than in extension movement (P = .002). MAIN LIMITATIONS The small number of specimens included. Excision of spines and removal of musculature. CONCLUSIONS The study is a first step in the investigation of the potential of dynamic 3D CT in veterinary medicine, a technique that has only begun to be explored and leaves much room for refinement prior to its introduction in routine practice. CT with a detector coverage of 16 cm and a rotation speed of 0.32 seconds provides high-quality images of moving objects and gives new insight into the movement pattern of equine cervical APJs.
Collapse
Affiliation(s)
- Nicole Schulze
- Equine Clinic, Surgery and Radiology, Freie Universität Berlin, Berlin, Germany
| | - Natasha Werpy
- Equine Diagnostic Imaging Inc., Archer, Florida, USA
| | - Jennifer Gernhardt
- Equine Clinic, Surgery and Radiology, Freie Universität Berlin, Berlin, Germany
| | - Guido Fritsch
- Leibniz Institute for Zoo and Wildlife Research, Forschungsverbund Berlin e.V., Berlin, Germany
| | - Thomas Hildebrandt
- Leibniz Institute for Zoo and Wildlife Research, Forschungsverbund Berlin e.V., Berlin, Germany
| | - Katrien Vanderperren
- Department of Veterinary Medical Imaging and Small Animal Orthopaedics, Ghent University, Ghent, Belgium
| | - Robert Klopfleisch
- Institute for Veterinary Pathology, Freie Universität Berlin, Berlin, Germany
| | - Racem Ben Romdhane
- Institute for Veterinary Epidemiology and Biostatistics, Freie Universität Berlin, Berlin, Germany
| | | | - Anna Ehrle
- Equine Clinic, Surgery and Radiology, Freie Universität Berlin, Berlin, Germany
| |
Collapse
|
5
|
Keelson B, Buzzatti L, Van Gompel G, Scheerlinck T, Hereus S, de Mey J, Cattrysse E, Vandemeulebroucke J, Buls N. The use of cardiac CT acquisition mode for dynamic musculoskeletal imaging. Phys Med 2022; 104:75-84. [PMID: 36370606 DOI: 10.1016/j.ejmp.2022.10.028] [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: 06/17/2022] [Revised: 09/30/2022] [Accepted: 10/31/2022] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVES To quantitatively evaluate the impact of a cardiac acquisition CT mode on motion artifacts in comparison to a conventional cine mode for dynamic musculoskeletal (MSK) imaging. METHODS A rotating PMMA phantom with air-filled holes drilled at varying distances from the disk center corresponding to linear hole speeds of 0.75 cm/s, 2.0 cm/s, and 3.6 cm/s was designed. Dynamic scans were obtained in cardiac and cine modes while the phantom was rotating at 48°/s in the CT scanner. An automated workflow to compute the Jaccard distance (JD) was established to quantify degree of motion artifacts in the reconstructed phantom images. JD values between the cardiac and cine scan modes were compared using a paired sample t-test. In addition, three healthy volunteers were scanned with both modes during a cyclic flexion-extension motion of the knee and analysed using the proposed metric. RESULTS For all hole sizes and speeds, the cardiac scan mode had significantly lower (p-value <0.001) JD values. (0.39 [0.32-0.46]) i.e less motion artifacts in comparison to the cine mode (0.72 [0.68-0.76]). For both modes, a progressive increase in JD was also observed as the linear speed of the holes increased from 0.75 cm/s to 3.6 cm/s. The dynamic images of the three healthy volunteers showed less artifacts when scanned in cardiac mode compared to cine mode, and this was quantitatively confirmed by the JD values. CONCLUSIONS A cardiac scan mode could be used to study dynamic musculoskeletal phenomena especially of fast-moving joints since it significantly minimized motion artifacts.
Collapse
Affiliation(s)
- Benyameen Keelson
- Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussels (UZB), Department of radiology, Laarbeeklaan 101, 1090 Brussels, Belgium; Vrije Universiteit Brussel (VUB), Department of Electronics and Informatics (ETRO), Pleinlaan 9, 1050 Brussels, Belgium; IMEC, Kapeldreef 75, B-3002 Leuven, Belgium.
| | - Luca Buzzatti
- Vrije Universiteit Brussel (VUB) Department of Physiotherapy, Human Physiology and Anatomy, Laarbeeklaan 103, 1090 Brussels, Belgium
| | - Gert Van Gompel
- Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussels (UZB), Department of radiology, Laarbeeklaan 101, 1090 Brussels, Belgium
| | - Thierry Scheerlinck
- Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Department of Orthopaedic Surgery and Traumatology, Laarbeeklaan 101, 1090 Brussels, Belgium
| | - Savanah Hereus
- Vrije Universiteit Brussel (VUB) Department of Physiotherapy, Human Physiology and Anatomy, Laarbeeklaan 103, 1090 Brussels, Belgium
| | - Johan de Mey
- Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussels (UZB), Department of radiology, Laarbeeklaan 101, 1090 Brussels, Belgium
| | - Erik Cattrysse
- Vrije Universiteit Brussel (VUB) Department of Physiotherapy, Human Physiology and Anatomy, Laarbeeklaan 103, 1090 Brussels, Belgium
| | - Jef Vandemeulebroucke
- Vrije Universiteit Brussel (VUB), Department of Electronics and Informatics (ETRO), Pleinlaan 9, 1050 Brussels, Belgium; IMEC, Kapeldreef 75, B-3002 Leuven, Belgium
| | - Nico Buls
- Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussels (UZB), Department of radiology, Laarbeeklaan 101, 1090 Brussels, Belgium
| |
Collapse
|
6
|
Dourthe B, Shaikh N, Pai S A, Fels S, Brown SHM, Wilson DR, Street J, Oxland TR. Automated Segmentation of Spinal Muscles From Upright Open MRI Using a Multiscale Pyramid 2D Convolutional Neural Network. Spine (Phila Pa 1976) 2022; 47:1179-1186. [PMID: 34919072 DOI: 10.1097/brs.0000000000004308] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 11/29/2021] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Randomized trial. OBJECTIVE To implement an algorithm enabling the automated segmentation of spinal muscles from open magnetic resonance images in healthy volunteers and patients with adult spinal deformity (ASD). SUMMARY OF BACKGROUND DATA Understanding spinal muscle anatomy is critical to diagnosing and treating spinal deformity.Muscle boundaries can be extrapolated from medical images using segmentation, which is usually done manually by clinical experts and remains complicated and time-consuming. METHODS Three groups were examined: two healthy volunteer groups (N = 6 for each group) and one ASD group (N = 8 patients) were imaged at the lumbar and thoracic regions of the spine in an upright open magnetic resonance imaging scanner while maintaining different postures (various seated, standing, and supine). For each group and region, a selection of regions of interest (ROIs) was manually segmented. A multiscale pyramid two-dimensional convolutional neural network was implemented to automatically segment all defined ROIs. A five-fold crossvalidation method was applied and distinct models were trained for each resulting set and group and evaluated using Dice coefficients calculated between the model output and the manually segmented target. RESULTS Good to excellent results were found across all ROIs for the ASD (Dice coefficient >0.76) and healthy (dice coefficient > 0.86) groups. CONCLUSION This study represents a fundamental step toward the development of an automated spinal muscle properties extraction pipeline, which will ultimately allow clinicians to have easier access to patient-specific simulations, diagnosis, and treatment.
Collapse
Affiliation(s)
- Benjamin Dourthe
- ICORD, Blusson Spinal Cord Centre, University of British Columbia, Vancouver, BC, Canada
- Department of Orthopaedics, University of British Columbia, Vancouver, BC, Canada
| | - Noor Shaikh
- Department of Orthopaedics, University of British Columbia, Vancouver, BC, Canada
- School of Biomedical Engineering, University of British Columbia, Vancouver, BC, Canada
- Depart-Department of Mechanical Engineering, University of British Columbia, Vancouver, BC, Canada
| | - Anoosha Pai S
- Department of Orthopaedics, University of British Columbia, Vancouver, BC, Canada
- School of Biomedical Engineering, University of British Columbia, Vancouver, BC, Canada
| | - Sidney Fels
- Electrical and Computer Engineering Department, University of British Columbia, Vancouver, BC, Canada
| | - Stephen H M Brown
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON, Canada
| | - David R Wilson
- ICORD, Blusson Spinal Cord Centre, University of British Columbia, Vancouver, BC, Canada
- Department of Orthopaedics, University of British Columbia, Vancouver, BC, Canada
- Centre for Hip Health and Mobility, University of British Columbia, Vancouver, BC, Canada
| | - John Street
- ICORD, Blusson Spinal Cord Centre, University of British Columbia, Vancouver, BC, Canada
- Department of Orthopaedics, University of British Columbia, Vancouver, BC, Canada
| | - Thomas R Oxland
- ICORD, Blusson Spinal Cord Centre, University of British Columbia, Vancouver, BC, Canada
- Department of Orthopaedics, University of British Columbia, Vancouver, BC, Canada
- Depart-Department of Mechanical Engineering, University of British Columbia, Vancouver, BC, Canada
| |
Collapse
|
7
|
Sciacca D, D'Agostino P, Vanneste M, Kerkhof F, Vereecke EE. In vivo quantification of the 3D kinematics and coupling of the thumb base joints. Med Eng Phys 2022; 106:103837. [DOI: 10.1016/j.medengphy.2022.103837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 06/08/2022] [Accepted: 06/14/2022] [Indexed: 11/17/2022]
|
8
|
Kerkhof F, Kenney D, Ogle M, Shelby T, Ladd A. The biomechanics of osteoarthritis in the hand: Implications and prospects for hand therapy. J Hand Ther 2022; 35:367-376. [PMID: 36509610 DOI: 10.1016/j.jht.2022.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND The unique anatomy of the human hand makes it possible to carefully manipulate tools, powerfully grasp objects, and even throw items with precision. These apparent contradictory functions of the hand, high mobility for manual dexterity vs high stability during forceful grasping, imply that daily activities impose a high strain on a relatively instable joint. This makes the hand susceptible to joint disorders such as osteoarthritis. Both systemic (eg, genetics, hormones) and mechanical factors (eg, joint loading) are important in the development of osteoarthritis, but the precise pathomechanism remains largely unknown. This paper focuses on the biomechanical factors in the disease process and how hand therapists can use this knowledge to improve treatment and research. CONCLUSION Multiple factors are involved in the onset and development of osteoarthritis in the hand. Comprehension of the biomechanics helps clinicians establish best practices for orthotics intervention, exercise, and joint protection programs even in de absence of clear evidence-based guidelines. The effect and reach of hand therapy for OA patients can be expanded substantially when intervention parameters are optimized and barriers to early referrals, access reimbursement, and adherence are addressed. Close and early collaboration between hand therapists and primary care, women's health, rheumatology, and hand surgery providers upon diagnosis, and with hand surgeons pre and postoperatively, combined with advances in the supporting science and strategies to enhance adherence, appear to be a promising way forward.
Collapse
Affiliation(s)
- Faes Kerkhof
- Chase Hand and Upper Limb Center, Stanford University, Palo Alto, CA, USA.
| | - Deborah Kenney
- Chase Hand and Upper Limb Center, Stanford University, Palo Alto, CA, USA
| | - Miranda Ogle
- Chase Hand and Upper Limb Center, Stanford University, Palo Alto, CA, USA
| | - Tara Shelby
- Chase Hand and Upper Limb Center, Stanford University, Palo Alto, CA, USA
| | - Amy Ladd
- Chase Hand and Upper Limb Center, Stanford University, Palo Alto, CA, USA
| |
Collapse
|
9
|
Zarenia M, Arpinar VE, Nencka AS, Muftuler LT, Koch KM. Dynamic tracking of scaphoid, lunate, and capitate carpal bones using four-dimensional MRI. PLoS One 2022; 17:e0269336. [PMID: 35653348 PMCID: PMC9162359 DOI: 10.1371/journal.pone.0269336] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Accepted: 05/18/2022] [Indexed: 11/18/2022] Open
Abstract
A preliminary exploration of technical methodology for dynamic analysis of scaphoid, capitate, and lunate during unconstrained movements is performed in this study. A heavily accelerated and fat-saturated 3D Cartesian MRI acquisition was used to capture temporal frames of the unconstrained moving wrist of 5 healthy subjects. A slab-to-volume point-cloud based registration was then utilized to register the moving volumes to a high-resolution image volume collected at a neutral resting position. Comprehensive in-silico error analyses for different acquisition parameter settings were performed to evaluate the performance limits of several dynamic metrics derived from the registration parameters. Computational analysis suggested that sufficient volume coverage for the dynamic acquisitions was reached when collecting 12 slice-encodes at 2.5mm resolution, which yielded a temporal resolution of and 2.6 seconds per volumetric frame. These acquisition parameters resulted in total in-silico errors of 1.9°±1.8° and 3°±4.6° in derived principal rotation angles within ulnar-radial deviation and flexion-extension motion, respectively. Rotation components of the carpal bones in the radius coordinate system were calculated and found to be consistent with earlier 4D-CT studies. Temporal metric profiles derived from ulnar-radial deviation motion demonstrated better performance than those derived from flexion/extension movements. Future work will continue to explore the use of these methods in deriving more complex dynamic metrics and their application to subjects with symptomatic carpal dysfunction.
Collapse
Affiliation(s)
- Mohammad Zarenia
- Department of Radiology, Medical College of Wisconsin, Milwaukee, WI, United States of America
- * E-mail:
| | - Volkan Emre Arpinar
- Department of Radiology, Medical College of Wisconsin, Milwaukee, WI, United States of America
| | - Andrew S. Nencka
- Department of Radiology, Medical College of Wisconsin, Milwaukee, WI, United States of America
| | - L. Tugan Muftuler
- Department of Radiology, Medical College of Wisconsin, Milwaukee, WI, United States of America
| | - Kevin M. Koch
- Department of Radiology, Medical College of Wisconsin, Milwaukee, WI, United States of America
| |
Collapse
|
10
|
Seah RB, Mak WK, Bryant K, Korlaet M, Dwyer A, Bain GI. Four-dimensional computed tomography scan for dynamic elbow disorders: recommendations for clinical utility. JSES Int 2022; 6:182-186. [PMID: 35141694 PMCID: PMC8811401 DOI: 10.1016/j.jseint.2021.09.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Four-dimensional computed tomography (4D CT) is rapidly emerging as a diagnostic tool for the investigation of dynamic upper limb disorders. Dynamic elbow pathologies are challenging to diagnose, and at present, limitations exist in current imaging modalities. OBJECTIVE We aimed to assess the clinical utility of 4D CT in detecting potential dynamic elbow disorders. METHODS Twenty-eight elbow joints from 26 patients with symptoms of dynamic elbow pathology were included in this study. They were first assessed by a senior orthopedic surgeon with subsequent qualitative data obtained via a Siemens Force Dual Source CT scanner (Erlangen, Germany), producing two- and three-dimensional "static" images and 4D dynamic "movie" images for assessment in each clinical scenario. Clinical assessment before and after scan was compared. RESULTS Use of 4D CT scan resulted in a change of diagnosis in 16 cases (57.14%). This included a change in primary diagnosis in 2 cases (7.14%) and secondary diagnosis in 14 cases (50%). In 25 cases (89.29%), the 4D CT scan allowed us to understand the pathological anatomy in greater detail which led to a change in the management plan of 15 cases (53.57%). CONCLUSION 4D CT is a promising diagnostic tool in the management of dynamic elbow disorders and may be considered in clinical practice. Future studies need to compare it with other diagnostic modalities such as three-dimensional CT.
Collapse
Affiliation(s)
| | - Wai-Keong Mak
- Department of Orthopaedic Surgery, Sengkang General Hospital, Singapore
| | - Kimberley Bryant
- Clinical and Research Imaging Centre, SAHMRI, Adelaide, SA, Australia
| | - Mishelle Korlaet
- Department of Orthopaedic Surgery and Trauma, Flinders University, Bedford Park, SA, Australia
| | - Andrew Dwyer
- Department of Orthopaedic Surgery and Trauma, Flinders University, Bedford Park, SA, Australia
| | - Gregory I. Bain
- Department of Orthopaedic Surgery and Trauma, Flinders University, Bedford Park, SA, Australia
| |
Collapse
|
11
|
Keelson B, Buzzatti L, Ceranka J, Gutiérrez A, Battista S, Scheerlinck T, Van Gompel G, De Mey J, Cattrysse E, Buls N, Vandemeulebroucke J. Automated Motion Analysis of Bony Joint Structures from Dynamic Computer Tomography Images: A Multi-Atlas Approach. Diagnostics (Basel) 2021; 11:diagnostics11112062. [PMID: 34829409 PMCID: PMC8621122 DOI: 10.3390/diagnostics11112062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 10/27/2021] [Accepted: 11/02/2021] [Indexed: 11/16/2022] Open
Abstract
Dynamic computer tomography (CT) is an emerging modality to analyze in-vivo joint kinematics at the bone level, but it requires manual bone segmentation and, in some instances, landmark identification. The objective of this study is to present an automated workflow for the assessment of three-dimensional in vivo joint kinematics from dynamic musculoskeletal CT images. The proposed method relies on a multi-atlas, multi-label segmentation and landmark propagation framework to extract bony structures and detect anatomical landmarks on the CT dataset. The segmented structures serve as regions of interest for the subsequent motion estimation across the dynamic sequence. The landmarks are propagated across the dynamic sequence for the construction of bone embedded reference frames from which kinematic parameters are estimated. We applied our workflow on dynamic CT images obtained from 15 healthy subjects on two different joints: thumb base (n = 5) and knee (n = 10). The proposed method resulted in segmentation accuracies of 0.90 ± 0.01 for the thumb dataset and 0.94 ± 0.02 for the knee as measured by the Dice score coefficient. In terms of motion estimation, mean differences in cardan angles between the automated algorithm and manual segmentation, and landmark identification performed by an expert were below 1°. Intraclass correlation (ICC) between cardan angles from the algorithm and results from expert manual landmarks ranged from 0.72 to 0.99 for all joints across all axes. The proposed automated method resulted in reproducible and reliable measurements, enabling the assessment of joint kinematics using 4DCT in clinical routine.
Collapse
Affiliation(s)
- Benyameen Keelson
- Department of Radiology, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), 1090 Brussels, Belgium; (A.G.); (G.V.G.); (J.D.M.); (N.B.); (J.V.)
- Department of Electronics and Informatics (ETRO), Vrije Universiteit Brussel (VUB), 1050 Brussels, Belgium;
- IMEC, Kapeldreef 75, B-3002 Leuven, Belgium
- Correspondence:
| | - Luca Buzzatti
- Department of Physiotherapy, Human Physiology and Anatomy (KIMA), Vrije Universiteit Brussel (VUB), Vrije Universiteit, 1090 Brussel, Belgium; (L.B.); (E.C.)
| | - Jakub Ceranka
- Department of Electronics and Informatics (ETRO), Vrije Universiteit Brussel (VUB), 1050 Brussels, Belgium;
- IMEC, Kapeldreef 75, B-3002 Leuven, Belgium
| | - Adrián Gutiérrez
- Department of Radiology, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), 1090 Brussels, Belgium; (A.G.); (G.V.G.); (J.D.M.); (N.B.); (J.V.)
| | - Simone Battista
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Campus of Savona, University of Genova, 17100 Savona, Italy;
| | - Thierry Scheerlinck
- Department of Orthopaedic Surgery and Traumatology, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), 1090 Brussels, Belgium;
| | - Gert Van Gompel
- Department of Radiology, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), 1090 Brussels, Belgium; (A.G.); (G.V.G.); (J.D.M.); (N.B.); (J.V.)
| | - Johan De Mey
- Department of Radiology, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), 1090 Brussels, Belgium; (A.G.); (G.V.G.); (J.D.M.); (N.B.); (J.V.)
| | - Erik Cattrysse
- Department of Physiotherapy, Human Physiology and Anatomy (KIMA), Vrije Universiteit Brussel (VUB), Vrije Universiteit, 1090 Brussel, Belgium; (L.B.); (E.C.)
| | - Nico Buls
- Department of Radiology, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), 1090 Brussels, Belgium; (A.G.); (G.V.G.); (J.D.M.); (N.B.); (J.V.)
| | - Jef Vandemeulebroucke
- Department of Radiology, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), 1090 Brussels, Belgium; (A.G.); (G.V.G.); (J.D.M.); (N.B.); (J.V.)
- Department of Electronics and Informatics (ETRO), Vrije Universiteit Brussel (VUB), 1050 Brussels, Belgium;
- IMEC, Kapeldreef 75, B-3002 Leuven, Belgium
| |
Collapse
|
12
|
Blum AG, van Holsbeeck MT, Bianchi S. Thumb Injuries and Instabilities. Part 1: Anatomy, Kinesiology, and Imaging Techniques of the Thumb. Semin Musculoskelet Radiol 2021; 25:346-354. [PMID: 34374068 DOI: 10.1055/s-0041-1730397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The unique anatomical characteristics of the thumb offer a broad range of motion and the ability to oppose thumb and finger, an essential function for grasping. The motor function of the thumb and its orientation make it particularly vulnerable to trauma. Pathologic lesions encountered in this joint are varied, and imaging techniques play a crucial role in injury detection and characterization. Despite advances in diagnostic accuracy, acute thumb injuries pose a challenge for the radiologist. The complex and delicate anatomy requires meticulous and technically flawless image acquisition. Standard radiography and ultrasonography are currently the most frequently used imaging techniques. Computed tomography is most often indicated for complex fractures and dislocations, and magnetic resonance imaging may be useful in equivocal cases. In this article, we present the relevant anatomy and imaging techniques of the thumb.
Collapse
Affiliation(s)
- Alain G Blum
- Guilloz Imaging Department, CHRU of Nancy, University of Lorraine, Nancy, France.,Unité INSERM U1254 Imagerie Adaptative Diagnostique et Interventionnelle (IADI), CHRU of Nancy, Vandœuvre-lès-Nancy, France
| | | | - Stefano Bianchi
- CIM SA, Cabinet d'imagerie Médicale, Geneva, Switzerland.,Service de Radiologie, Hôpitaux Universitaires de Genève, Geneva, Switzerland
| |
Collapse
|
13
|
Fontaine C, D'Agostino P, Maes-Clavier C, Boutan M, Sturbois-Nachef N. Anatomy and biomechanics of healthy and arthritic trapeziometacarpal joints. HAND SURGERY & REHABILITATION 2021; 40S:S3-S14. [PMID: 34118467 DOI: 10.1016/j.hansur.2020.09.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 09/18/2020] [Accepted: 09/29/2020] [Indexed: 10/21/2022]
Abstract
Understanding the biomechanics of the trapeziometacarpal (TMC) or first carpometacarpal (CMC1) joint, the pathophysiology of basal thumb arthritis, the design and performance of surgical procedures require a solid anatomical basis. This review of literature summarizes the most recent data on the descriptive, functional, and comparative anatomy of healthy and arthritic TMC joints.
Collapse
Affiliation(s)
- C Fontaine
- Laboratoire d'Anatomie et Organogenèse, Faculté de Médecine Henri Warembourg, Université de Lille, Rue Michel Polonovski, 59045 Lille cedex, France; Laboratoire d'Automatique, de Mécanique et d'Informatique Industrielle et Humaine LAMIH, Université de Valenciennes et du Hainaut-Cambrésis, Le Mont Houy, 59313 Valenciennes cedex, France; Clinique de Traumatologie-Orthopédie, Hôpital Roger Salengro, Rue du Professeur Emile Laine, CHRU de Lille, 59037 Lille cedex, France.
| | - P D'Agostino
- Clinique de la Main, Bruxelles et Brabant-Wallon, Avenue Louise 284, 1050 Bruxelles, Belgique
| | - C Maes-Clavier
- Service de Chirurgie Orthopédique et Traumatologique, CHU Amiens-Picardie, Site sud Route départementale 408, 80054 Amiens cedex 1, France
| | - M Boutan
- Résidence Dryades, Bâtiment A1, 1, rue du 11 novembre, 40990 Saint-Paul-les-Dax, France
| | - N Sturbois-Nachef
- Clinique de Traumatologie-Orthopédie, Hôpital Roger Salengro, Rue du Professeur Emile Laine, CHRU de Lille, 59037 Lille cedex, France
| |
Collapse
|
14
|
Vanneste M, Stockmans F, Vereecke EE. The effect of orthoses on the kinematics of the trapeziometacarpal, scaphotrapeziotrapezoidal, and radioscaphoid joints. J Orthop Res 2021; 39:196-203. [PMID: 32301523 DOI: 10.1002/jor.24700] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 02/12/2020] [Accepted: 03/28/2020] [Indexed: 02/04/2023]
Abstract
The in vivo effect of four different types of thumb and thumb-wrist orthoses on the three-dimensional kinematics of the trapeziometacarpal (TMC), scaphotrapeziotrapezoidal (STT) and radioscaphoid joints was quantified using computed tomography (CT). Eighteen healthy female volunteers were recruited. The dominant hand of each subject was scanned in four thumb and wrist positions, each in three conditions: without orthosis, with a thumb orthosis (Push Ortho and immediate fitting, IMF) and with a thumb-wrist orthosis (Ligaflex Manu and IMF). CT images were analyzed and rotations relative to the more proximal bone were expressed in a joint-specific coordinate system. Without orthosis, the largest STT rotations were observed during radioulnar deviation of the wrist and the STT range of motion (ROM) was significantly lower during wrist flexion-extension. All tested orthoses caused a significant reduction of the ROM at each joint compared to free motion. Significant differences in movement reduction were observed between prefabricated and IMF orthoses.The IMF thumb-wrist outperformed the Ligaflex Manu in terms of immobilization of the radioscaphoid joint. In addition, the IMF thumb orthosis immobilized the TMC joint significantly better during thumb abduction and adduction than the Push Ortho. We found that different types of thumb and thumb-wrist orthotics are effective in reducing joint mobility. While this reduction tends to be higher using IMF compared to prefabricated orthoses, this effect is only significant for the radioscaphoid and TMC joint. The finding that thumb movements do not induce large STT rotations suggests that the thumb does not need to be immobilized in case of isolated STT osteoarthritis.
Collapse
Affiliation(s)
- Maarten Vanneste
- Department of Development and Regeneration, Muscles and Movement, Biomedical Sciences Group, KU Leuven, Kortrijk, Belgium.,V!go N.V., Belgium
| | - Filip Stockmans
- Department of Development and Regeneration, Muscles and Movement, Biomedical Sciences Group, KU Leuven, Kortrijk, Belgium.,AZ Groeninge, Kortrijk, Belgium
| | - Evie E Vereecke
- Department of Development and Regeneration, Muscles and Movement, Biomedical Sciences Group, KU Leuven, Kortrijk, Belgium
| |
Collapse
|
15
|
Engelhardt L, Melzner M, Havelkova L, Fiala P, Christen P, Dendorfer S, Simon U. A new musculoskeletal AnyBody™ detailed hand model. Comput Methods Biomech Biomed Engin 2020; 24:1-11. [PMID: 33300810 DOI: 10.1080/10255842.2020.1851367] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 10/13/2020] [Accepted: 11/11/2020] [Indexed: 10/22/2022]
Abstract
Musculoskeletal research questions regarding the prevention or rehabilitation of the hand can be addressed using inverse dynamics simulations when experiments are not possible. To date, no complete human hand model implemented in a holistic human body model has been fully developed. The aim of this work was to develop, implement, and validate a fully detailed hand model using the AnyBody Modelling System (AMS) (AnyBody, Aalborg, Denmark). To achieve this, a consistent multiple cadaver dataset, including all extrinsic and intrinsic muscles, served as a basis. Various obstacle methods were implemented to obtain with the correct alignment of the muscle paths together with the full range of motion of the fingers. These included tori, cylinders, and spherical ellipsoids. The origin points of the lumbrical muscles within the tendon of the flexor digitorum profundus added a unique feature to the model. Furthermore, the possibility of an entire patient-specific scaling based on the hand length and width were implemented in the model. For model validation, experimental datasets from the literature were used, which included the comparison of numerically calculated moment arms of the wrist, thumb, and index finger muscles. In general, the results displayed good comparability of the model and experimental data. However, the extrinsic muscles showed higher accordance than the intrinsic ones. Nevertheless, the results showed, that the proposed developed inverse dynamics hand model offers opportunities in a broad field of applications, where the muscles and joint forces of the forearm play a crucial role.
Collapse
Affiliation(s)
- Lucas Engelhardt
- Scientific Computing Centre Ulm (UZWR), Ulm University, Ulm, Germany
| | - Maximilian Melzner
- Laboratory for Biomechanics, Ostbayerische Technische Hochschule (OTH) Regensburg, Regensburg, Germany
- Regensburg Center of Biomedical Engineering, OTH and University Regensburg, Regensburg, Germany
| | - Linda Havelkova
- New Technologies Research Centre, University of West Bohemia (UWB), Plzen, Czech Republic
| | - Pavel Fiala
- Department of Anatomy, Faculty of Medicine in Pilsen, Charles University, Plzen, Czech Republic
| | - Patrik Christen
- Institute for Biomechanics, ETH Zurich, Zurich, Switzerland
- Institute for Information Systems, University of Applied Sciences and Arts Northwestern, Brugg, Switzerland
| | - Sebastian Dendorfer
- Laboratory for Biomechanics, Ostbayerische Technische Hochschule (OTH) Regensburg, Regensburg, Germany
- Regensburg Center of Biomedical Engineering, OTH and University Regensburg, Regensburg, Germany
| | - Ulrich Simon
- Scientific Computing Centre Ulm (UZWR), Ulm University, Ulm, Germany
| |
Collapse
|
16
|
Quantitative analysis of metacarpophalangeal joints during active flexion using four-dimensional computed tomography. Clin Biomech (Bristol, Avon) 2020; 80:105188. [PMID: 33080527 DOI: 10.1016/j.clinbiomech.2020.105188] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Revised: 08/27/2020] [Accepted: 09/28/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND The metacarpophalangeal joint has a unique morphology with a high degree of freedom. However, few studies have analyzed the kinematics of fingers owing to the rapid movement of the small bones involved. The in-vivo kinematics of metacarpophalangeal joints were analyzed by four-dimensional computed tomography (4DCT) and associated with its morphology. METHODS The flexion motion of the fingers of bilateral hands in 10 volunteers were examined using 4DCT. Iterative surfaces were registered to trace the surface of the proximal phalanges with respect to metacarpals. Rotation angles were calculated using Euler/Cardan angles. FINDINGS In the index finger, the proximal phalange supinated to a maximum flexion of 40° and then pronated, and its range of rotation was larger than the previous reports. In the other fingers, the proximal phalanges continued to supinate during flexion. The helical axis of the proximal phalange passed a point extremely close to the center point of bilateral condyles, and it moved toward the proximal and palmar directions until the middle stage of flexion and toward the proximal and dorsal directions during the late stage of flexion. The translation of the rotation axis was larger in the ring and little fingers. INTERPRETATION The rotation in the index finger was larger than previously reported. The helical axes moved in the dorsal direction and proximally during the latter phase of the flexion. These results can be employed to better understand the causes of implant failure of the metacarpophalangeal joints.
Collapse
|
17
|
Wilkens SC, Meghpara MM, Ring D, Coert JH, Jupiter JB, Chen NC. Trapeziometacarpal Arthrosis. JBJS Rev 2020; 7:e8. [PMID: 30672779 DOI: 10.2106/jbjs.rvw.18.00020] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- Suzanne C Wilkens
- Hand and Upper Extremity Service, Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Michael M Meghpara
- Hand and Upper Extremity Service, Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - David Ring
- Department of Surgery and Perioperative Care, Dell Medical School at the University of Texas at Austin, Austin, Texas
| | - J Henk Coert
- Department of Plastic Surgery and Hand Surgery, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Jesse B Jupiter
- Hand and Upper Extremity Service, Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Neal C Chen
- Hand and Upper Extremity Service, Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| |
Collapse
|
18
|
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.
Collapse
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
| |
Collapse
|
19
|
Wang KK, Zhang X, McCombe D, Ackland DC, Ek ET, Tham SK. Quantitative analysis of in-vivo thumb carpometacarpal joint kinematics using four-dimensional computed tomography. J Hand Surg Eur Vol 2018; 43:1088-1097. [PMID: 30068246 DOI: 10.1177/1753193418789828] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The purpose of this study was to define the normal thumb carpometacarpal joint kinematics in-vivo during opposition and abduction using four-dimensional computed-tomography in four volunteers. Movement of the metacarpal relative to the trapezium was quantified using both Euler and helical axis representations. Articular surface contact patterns were also analysed. The overall axis of rotation for the movement of opposition and abduction passes through the trapezium and the base of the proximal phalanx, respectively. An abrupt change in instantaneous axis of rotation at terminal opposition was found. Ligament modelling shows dorsoradial ligament becomes tauter towards terminal opposition, whereas anterior oblique ligament becomes more slack. These results support the existence of the 'screw-home' pivot at terminal opposition and the importance of the dorsoradial ligament for stability in this position. The normal reference set in this study can help establish a diagnostic tool for subtle carpometacarpal instability, or for evaluating efficacy of surgery.
Collapse
Affiliation(s)
- Kemble K Wang
- 1 Hand Surgery Unit, Dandenong Hospital, Monash University, Melbourne, Australia.,2 Hand and Wrist Biomechanics Laboratory (HWBL), O'Brien Institute, Melbourne, Australia
| | - Xin Zhang
- 2 Hand and Wrist Biomechanics Laboratory (HWBL), O'Brien Institute, Melbourne, Australia.,3 Department of Biomechanical Engineering, University of Melbourne, Melbourne, Australia
| | - David McCombe
- 2 Hand and Wrist Biomechanics Laboratory (HWBL), O'Brien Institute, Melbourne, Australia.,4 Hand Surgery Unit, St Vincent's Hospital, Melbourne, Australia
| | - David C Ackland
- 2 Hand and Wrist Biomechanics Laboratory (HWBL), O'Brien Institute, Melbourne, Australia.,3 Department of Biomechanical Engineering, University of Melbourne, Melbourne, Australia
| | - Eugene T Ek
- 1 Hand Surgery Unit, Dandenong Hospital, Monash University, Melbourne, Australia.,2 Hand and Wrist Biomechanics Laboratory (HWBL), O'Brien Institute, Melbourne, Australia
| | - Stephen K Tham
- 1 Hand Surgery Unit, Dandenong Hospital, Monash University, Melbourne, Australia.,2 Hand and Wrist Biomechanics Laboratory (HWBL), O'Brien Institute, Melbourne, Australia.,4 Hand Surgery Unit, St Vincent's Hospital, Melbourne, Australia
| |
Collapse
|
20
|
Kerkhof FD, Vereecke EE, Vanovermeire O, Vanhaecke J, Vanneste M, Stockmans F. Trapeziometacarpal stabilization through dorsoradial ligament reconstruction: An early post-surgery in vivo biomechanical analyses. J Orthop Res 2018; 36:2851-2864. [PMID: 29947128 DOI: 10.1002/jor.24103] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Accepted: 06/18/2018] [Indexed: 02/04/2023]
Abstract
Ligament reconstruction can provide pain relief in patients with a painful, unstable, pre-arthritic trapeziometacarpal (TMC) joint. Imbrication of the dorsoradial ligament (DRL) has been proposed as a minimal invasive stabilization technique. It requires less invasive surgery than an Eaton-Littler technique and shows promising long-term clinical outcome. We used dynamic CT to objectively review the effects of the imbrication. Four patients with pain and laxity at the TMC joint, but without radiographic signs of osteoarthritis, were recruited. Dynamic CT scans were made during active thumb abduction-adduction, flexion-extension, and two functional grip tasks using a radiolucent jig. Scans of the patients were acquired before and 3 to 6 months after DRL reconstruction. Motion of each bone in the articular chain of the thumb was quantified. In addition, we mapped changes in the contact patterns between the articular facets during the entire thumb motion. After DRL imbrication, we found no overall decrease in MC1 movement in three out of four patients. Furthermore, no increase in TMC joint congruency, defined as proximity area size, was found for three out of four patients. Pre- and post-operative differences in congruency across different tasks were patient-dependent and relatively small. We demonstrated that, from a biomechanical perspective, there is high variability in post-operative outcome between patients that undergo identical surgical procedures performed by the same surgeon. A post-operative decrease in range of motion, increase in joint congruency or decrease in proximity area shift during thumb motion is not omnipresent. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:2851-2864, 2018.
Collapse
Affiliation(s)
- Faes D Kerkhof
- Department of Development and Regeneration, KU Leuven Campus Kulak, Kortrijk, Belgium
| | - Evie E Vereecke
- Department of Development and Regeneration, KU Leuven Campus Kulak, Kortrijk, Belgium
| | | | | | - Maarten Vanneste
- Department of Development and Regeneration, KU Leuven Campus Kulak, Kortrijk, Belgium
| | - Filip Stockmans
- Department of Development and Regeneration, KU Leuven Campus Kulak, Kortrijk, Belgium.,AZ Groeninge, Kortrijk, Belgium
| |
Collapse
|
21
|
D'Agostino P, Dourthe B, Kerkhof F, Vereecke EE, Stockmans F. Impact of Osteoarthritis and Total Joint Arthroplasty on the Kinematics of the Trapeziometacarpal Joint: A Pilot Study. J Hand Surg Am 2018; 43:382.e1-382.e10. [PMID: 29146507 DOI: 10.1016/j.jhsa.2017.10.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Revised: 09/16/2017] [Accepted: 10/10/2017] [Indexed: 02/02/2023]
Abstract
PURPOSE To quantify the effect of osteoarthritis (OA) and total trapeziometacarpal (TMC) joint replacement on thumb kinematics during the primary physiological motions of the thumb. METHODS We included 4 female patients with stage III TMC OA. A computed tomography-based markerless method was used to quantify the 3-dimensional thumb kinematics in patients before and after TMC joint replacement surgery with the Arpe implant. RESULTS Trapeziometacarpal OA led to a marked decrease of internal rotation and abduction of the first metacarpal (MC1) during thumb flexion and a decrease of MC1 adduction during thumb adduction. As a compensatory phenomenon, the trapezium displayed increased abduction. The absence of MC1 translation in the ball-and-socket implant seems to induce a decrease of MC1 adduction as well as a decrease of trapezium adduction during thumb adduction, compared with OA and healthy joints. Implant replacement displayed an unchanged MC1 flexion during thumb flexion and seemed to slightly increase MC1 axial rotation during thumb flexion and adduction. Abduction and adduction of the MC1 are limited and compensated by this somewhat increased axial rotation, allowing more efficient thumb opposition. CONCLUSIONS The study highlights that advanced TMC OA mainly restricts the MC1 mobility. We also showed that, whereas total joint arthroplasty is able to restore thumb function, it cannot fully replicate the kinematics of the healthy TMC joint. CLINICAL RELEVANCE The quantification of TMC joint kinematics in OA and implanted patients is essential to improve our understanding of TMC OA as well as to enhance the functionality of implant designs.
Collapse
Affiliation(s)
- Priscilla D'Agostino
- Muscles & Movement, Department of Development and Regeneration, Biomedical Sciences Group, Kulak, Belgium; Louise Hand Clinic, Brussels, Belgium; Europe Clinic, St-Elisabeth Clinic, Brussels, Belgium.
| | - Benjamin Dourthe
- Muscles & Movement, Department of Development and Regeneration, Biomedical Sciences Group, Kulak, Belgium
| | - Faes Kerkhof
- Muscles & Movement, Department of Development and Regeneration, Biomedical Sciences Group, Kulak, Belgium
| | - Evie E Vereecke
- Muscles & Movement, Department of Development and Regeneration, Biomedical Sciences Group, Kulak, Belgium
| | - Filip Stockmans
- Muscles & Movement, Department of Development and Regeneration, Biomedical Sciences Group, Kulak, Belgium; Handgroep, AZ Groeninge, Kortrijk, Belgium
| |
Collapse
|
22
|
D'Agostino P, Dourthe B, Kerkhof F, Harry Van Lenthe G, Stockmans F, Vereecke EE. In vivo biomechanical behavior of the trapeziometacarpal joint in healthy and osteoarthritic subjects. Clin Biomech (Bristol, Avon) 2017; 49:119-127. [PMID: 28934632 DOI: 10.1016/j.clinbiomech.2017.09.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2017] [Revised: 09/05/2017] [Accepted: 09/11/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND The contact biomechanics of the trapeziometacarpal joint have been investigated in several studies. However, these led to conflicting results and were mostly performed in vitro. The purpose of this study was to provide further insight on the contact biomechanics of the trapeziometacarpal joint by in vivo assessment of healthy and osteoarthritic subjects. METHODS The hands of 16 healthy women and 6 women with trapeziometacarpal osteoarthritis were scanned in positions of maximal thumb extension, flexion, abduction and adduction during three isometric tasks (lateral key pinch, power grasp and jar twist) and in thumb rest posture (relaxed neutral). Three-dimensional surface models of the trapezium and first metacarpal were created for each thumb configuration. The articular surface of each bone was measured in the neutral posture. A computed tomography-based proximity mapping algorithm was developed to calculate the distance between opposing joint surfaces, which was used as a surrogate for intra-articular stress. FINDINGS Distinct proximity patterns were observed across tasks with a recurrent pattern reported on the volar aspect of the first metacarpal. The comparison between healthy and arthritic subjects showed a significantly larger articular area, in parallel with a significant joint space narrowing and an increase in proximity area in arthritic subjects. We also observed severe articular deformations in subjects with late stage osteoarthritis. INTERPRETATION This study has increased our insight in the contact biomechanics of the trapeziometacarpal joint during tasks and positions of daily life in healthy and arthritic subjects, which might contribute to a better understanding of the occurrence mechanisms of degenerative diseases such as osteoarthritis.
Collapse
Affiliation(s)
- Priscilla D'Agostino
- Muscles & Movement, Department of Development and Regeneration, Biomedical Sciences Group, KU Leuven Campus Kulak, Kortrijk, Belgium; Louise Hand Clinic, Brussels, Belgium; Europe Clinic, St-Elisabeth Clinic, Brussels, Belgium.
| | - Benjamin Dourthe
- Muscles & Movement, Department of Development and Regeneration, Biomedical Sciences Group, KU Leuven Campus Kulak, Kortrijk, Belgium
| | - Faes Kerkhof
- Muscles & Movement, Department of Development and Regeneration, Biomedical Sciences Group, KU Leuven Campus Kulak, Kortrijk, Belgium
| | - G Harry Van Lenthe
- Biomechanics Section, Science, Engineering & Technology Group, KU Leuven, Leuven, Belgium
| | - Filip Stockmans
- Muscles & Movement, Department of Development and Regeneration, Biomedical Sciences Group, KU Leuven Campus Kulak, Kortrijk, Belgium; Handgroep, AZ Groeninge, Kortrijk, Belgium
| | - Evie E Vereecke
- Muscles & Movement, Department of Development and Regeneration, Biomedical Sciences Group, KU Leuven Campus Kulak, Kortrijk, Belgium
| |
Collapse
|
23
|
D'Agostino P, Dourthe B, Kerkhof F, Stockmans F, Vereecke EE. In vivo kinematics of the thumb during flexion and adduction motion: Evidence for a screw-home mechanism. J Orthop Res 2017; 35:1556-1564. [PMID: 27606961 DOI: 10.1002/jor.23421] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Accepted: 09/06/2016] [Indexed: 02/04/2023]
Abstract
The thumb plays a crucial role in basic hand function. However, the kinematics of its entire articular chain have not yet been quantified. Such investigation is essential to improve our understanding of thumb function and to develop better strategies to treat thumb joint pathologies. The primary objective of this study is to quantify the in vivo kinematics of the trapeziometacarpal (TMC) and scaphotrapezial (ST) joints during flexion and adduction of the thumb. In addition, we want to evaluate the potential coupling between the TMC and ST joints during these tasks. The hand of 16 asymptomatic women without signs of thumb osteoarthritis were CT scanned in positions of maximal thumb extension, flexion, abduction, and adduction. The CT images were segmented and three-dimensional surface models of the radius, scaphoid, trapezium, and the first metacarpal were created for each thumb motion. The corresponding rotations angles, translations, and helical axes were calculated for each sequence. The analysis shows that flexion and adduction of the thumb result in a three-dimensional rotation and translation of the entire articular chain, including the trapezium and scaphoid. A wider range of motion is observed for the first metacarpal, which displays a clear axial rotation. The coupling of axial rotation of the first metacarpal with flexion and abduction during thumb flexion supports the existence of a screw-home mechanism in the TMC joint. In addition, our results point to a potential motion coupling between the TMC and ST joints and underline the complexity of thumb kinematics. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:1556-1564, 2017.
Collapse
Affiliation(s)
- Priscilla D'Agostino
- Department of Development and Regeneration, Muscles and Movement, Biomedical Sciences Group, KU Leuven Kulak, Etienne Sabbelaan 53, B-8500 Kortrijk, Belgium.,Louise Hand Clinic, Brussels, Belgium.,Europe Clinic, St-Elisabeth Clinic, Brussels, Belgium
| | - Benjamin Dourthe
- Department of Development and Regeneration, Muscles and Movement, Biomedical Sciences Group, KU Leuven Kulak, Etienne Sabbelaan 53, B-8500 Kortrijk, Belgium
| | - Faes Kerkhof
- Department of Development and Regeneration, Muscles and Movement, Biomedical Sciences Group, KU Leuven Kulak, Etienne Sabbelaan 53, B-8500 Kortrijk, Belgium
| | - Filip Stockmans
- Department of Development and Regeneration, Muscles and Movement, Biomedical Sciences Group, KU Leuven Kulak, Etienne Sabbelaan 53, B-8500 Kortrijk, Belgium.,Handgroep, AZ Groeninge, Kortrijk, Belgium
| | - Evie E Vereecke
- Department of Development and Regeneration, Muscles and Movement, Biomedical Sciences Group, KU Leuven Kulak, Etienne Sabbelaan 53, B-8500 Kortrijk, Belgium
| |
Collapse
|