1
|
Gomez-Cerezo MN, Perevoshchikova N, Ruan R, Moerman KM, Bindra R, Lloyd DG, Zheng MH, Saxby DJ, Vaquette C. Additively manufactured polyethylene terephthalate scaffolds for scapholunate interosseous ligament reconstruction. BIOMATERIALS ADVANCES 2023; 149:213397. [PMID: 37023566 DOI: 10.1016/j.bioadv.2023.213397] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 03/13/2023] [Accepted: 03/17/2023] [Indexed: 03/29/2023]
Abstract
The regeneration of the ruptured scapholunate interosseous ligament (SLIL) represents a clinical challenge. Here, we propose the use of a Bone-Ligament-Bone (BLB) 3D-printed polyethylene terephthalate (PET) scaffold for achieving mechanical stabilisation of the scaphoid and lunate following SLIL rupture. The BLB scaffold featured two bone compartments bridged by aligned fibres (ligament compartment) mimicking the architecture of the native tissue. The scaffold presented tensile stiffness in the range of 260 ± 38 N/mm and ultimate load of 113 ± 13 N, which would support physiological loading. A finite element analysis (FEA), using inverse finite element analysis (iFEA) for material property identification, showed an adequate fit between simulation and experimental data. The scaffold was then biofunctionalized using two different methods: injected with a Gelatin Methacryloyl solution containing human mesenchymal stem cell spheroids (hMSC) or seeded with tendon-derived stem cells (TDSC) and placed in a bioreactor to undergo cyclic deformation. The first approach demonstrated high cell viability, as cells migrated out of the spheroid and colonised the interstitial space of the scaffold. These cells adopted an elongated morphology suggesting the internal architecture of the scaffold exerted topographical guidance. The second method demonstrated the high resilience of the scaffold to cyclic deformation and the secretion of a fibroblastic related protein was enhanced by the mechanical stimulation. This process promoted the expression of relevant proteins, such as Tenomodulin (TNMD), indicating mechanical stimulation may enhance cell differentiation and be useful prior to surgical implantation. In conclusion, the PET scaffold presented several promising characteristics for the immediate mechanical stabilisation of disassociated scaphoid and lunate and, in the longer-term, the regeneration of the ruptured SLIL.
Collapse
|
2
|
Gill D, Lyer S, Alexiou C, Fried F, Buder T, Neuhuber W, Jacxsens M, Horch RE, Arkudas A. Anatomical Study of all Carpal and Adjoining Bones of the Wrist using 3D CT Reconstruction - Finding the ultimate Biomechanical Theory. Ann Anat 2022; 242:151909. [PMID: 35189269 DOI: 10.1016/j.aanat.2022.151909] [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: 04/28/2021] [Revised: 11/28/2021] [Accepted: 01/30/2022] [Indexed: 10/19/2022]
Abstract
BACKGROUND The complex interplay of single wrist bones acting in combination with their ligamentous connections is still not fully understood. In this regard various theories exist, divisible in columnar and ring/row theories. The object of this study was to examine the mobility of the individual carpal bones as well as the ulna and metacarpals relative to each other in wrists of cadaveric hands using CT scans. METHODS The regular wrist mobility of a total of 21 cadaveric hands was examined by CT imaging in neutral position, radial/ulnar abduction as well as wrist flexion and extension. The data were evaluated as 3D models by using a standardized global coordinate system and object coordinate systems. Rotation and translation of each carpal bone as well as radius/ulna and all metacarpal bones were evaluated. RESULTS The principal motion took place in the carpus between the radius and the proximal carpal row followed by the midcarpal joint and the carpometacarpal joints and not mainly between the individual bones of a row. The scaphoid moves out of its row aggregate mainly during flexion and adapts to the motion of the distal carpal row. The trapezium and first metacarpal bones play a specific role detached from the remaining bones. CONCLUSIONS With this study, a better understanding of the motion of the individual bones of the carpus, the metacarpals and the radius/ulna is shown. The study supports the row theory, where most motion takes place between the individual rows and not between the carpal bones, leaving the scaphoid and the first ray in a special role between the rows.
Collapse
Affiliation(s)
- Dominik Gill
- Department of Plastic and Hand Surgery, Laboratory for Tissue Engineering and Regenerative Medicine, University Hospital Erlangen, Friedrich Alexander University Erlangen-Nuernberg FAU, Erlangen, Germany
| | - Stefan Lyer
- Department of Otorhinolaryngology, Head & Neck Surgery, Section of Experimental Oncology & Nanomedicine (SEON), Else Kröner-Fresenius-Stiftung-Professorship, Universitätsklinikum Erlangen, Friedrich-Alexander-University Erlangen-Nuernberg FAU, Erlangen, Germany
| | - Christoph Alexiou
- Department of Otorhinolaryngology, Head & Neck Surgery, Section of Experimental Oncology & Nanomedicine (SEON), Else Kröner-Fresenius-Stiftung-Professorship, Universitätsklinikum Erlangen, Friedrich-Alexander-University Erlangen-Nuernberg FAU, Erlangen, Germany
| | - Frederik Fried
- Department of Plastic and Hand Surgery, Laboratory for Tissue Engineering and Regenerative Medicine, University Hospital Erlangen, Friedrich Alexander University Erlangen-Nuernberg FAU, Erlangen, Germany
| | - Thomas Buder
- Institute of Anatomy and Cell Biology, Chair I, Friedrich Alexander University Erlangen-Nuernberg FAU, Erlangen, Germany
| | - Winfried Neuhuber
- Institute of Anatomy and Cell Biology, Chair I, Friedrich Alexander University Erlangen-Nuernberg FAU, Erlangen, Germany
| | - Matthijs Jacxsens
- Department of Orthopaedic Surgery and Traumatology, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - Raymund E Horch
- Department of Plastic and Hand Surgery, Laboratory for Tissue Engineering and Regenerative Medicine, University Hospital Erlangen, Friedrich Alexander University Erlangen-Nuernberg FAU, Erlangen, Germany
| | - Andreas Arkudas
- Department of Plastic and Hand Surgery, Laboratory for Tissue Engineering and Regenerative Medicine, University Hospital Erlangen, Friedrich Alexander University Erlangen-Nuernberg FAU, Erlangen, Germany.
| |
Collapse
|
3
|
In Vivo Measurement of Wrist Movements during the Dart-Throwing Motion Using Inertial Measurement Units. SENSORS 2021; 21:s21165623. [PMID: 34451068 PMCID: PMC8402613 DOI: 10.3390/s21165623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 08/11/2021] [Accepted: 08/18/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND This study investigates the dart-throwing motion (DTM) by comparing an inertial measurement unit-based system previously validated for basic motion tasks with an optoelectronic motion capture system. The DTM is interesting as wrist movement during many activities of daily living occur in this movement plane, but the complex movement is difficult to assess clinically. METHODS Ten healthy subjects were recorded while performing the DTM with their right wrist using inertial sensors and skin markers. Maximum range of motion obtained by the different systems and the mean absolute difference were calculated. RESULTS In the flexion-extension plane, both systems calculated a range of motion of 100° with mean absolute differences of 8°, while in the radial-ulnar deviation plane, a mean absolute difference of 17° and range of motion values of 48° for the optoelectronic system and 59° for the inertial measurement units were found. CONCLUSIONS This study shows the challenge of comparing results of different kinematic motion capture systems for complex movements while also highlighting inertial measurement units as promising for future clinical application in dynamic and coupled wrist movements. Possible sources of error and solutions are discussed.
Collapse
|
4
|
Politikou O, Reissner L, Besmens IS, Calcagni M. Arthroscopic three-corner or lunocapitate arthrodesis: technical tips and early outcomes. J Plast Surg Hand Surg 2021; 56:138-144. [PMID: 34313544 DOI: 10.1080/2000656x.2021.1951744] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The purpose of the study is to present a technical approach for arthroscopic three-corner or lunocapitate arthrodesis with mini-open scaphoid excision and to report about the early clinical and functional results. The median surgery time was 112 min with shorter times achieved once mastering the technique. Radiological and clinical union was observed in 11 out of 12 patients in a median time of five months. For final assessments nine patients were included with a median follow-up of 15 months. Wrist extension and flexion after surgery decreased to 58 and 62% of preoperative measurements and represented 37 and 42% of the unaffected side. Grip strength also decreased to 80% of the preoperative value and 57% of the unaffected side. All patients reported significant pain relief and functional improvement. Arthroscopic three-corner or lunocapitate arthrodesis was a safe, reliable and minimally invasive technique for treating wrist osteoarthritis, while it was technically demanding and time-consuming during learning curve.
Collapse
Affiliation(s)
- Olga Politikou
- Clinical Laboratory for Bionic Extremity Reconstruction, Department of Plastic, Reconstructive and Aesthetic Surgery, Medical University of Vienna, Austria
| | - Lisa Reissner
- Orthopaedics Department, University Hospital Balgrist, Zurich, Switzerland
| | - Inga S Besmens
- Division of Plastic Surgery and Hand Surgery, University Hospital Zurich, Switzerland
| | - Maurizio Calcagni
- Division of Plastic Surgery and Hand Surgery, University Hospital Zurich, Switzerland
| |
Collapse
|