The Effect of the Joint Capsule and Anterior Oblique Ligament on Dorsal Subluxation of the First Metacarpal During Key Pinch

2020 ◽  
Vol 142 (6) ◽  
Author(s):  
Nolan M. Norton ◽  
Brandon Barnds ◽  
Terence E. McIff ◽  
Toby E. Bruce ◽  
Kenneth J. Fischer
Keyword(s):  
Joint Instability ◽  
Joint Capsule ◽  
Joint Mechanics ◽  
Trapeziometacarpal Joint ◽  
Substantial Role ◽  
Stress Radiographs ◽  
Joint Contact ◽  
Anterior Oblique Ligament ◽  
Open Joint ◽  
Contact Pressures

Abstract Laxity of the anterior oblique ligament (AOL) and/or the dorsoradial ligament (DRL) are believed to contribute to the progression of osteoarthritis in the trapeziometacarpal joint through increased dorsal subluxation. Stress radiographs during functional tasks, such as key pinch, can be used to evaluate such joint instability. Cadaveric experiments can explore joint contact pressures as well as subluxation under varying conditions, to gain knowledge about joint mechanics. The disturbance of supporting tissues, such as the joint capsule, during experiments may affect the recorded stability of the joint. To evaluate potential effects of opening the joint capsule and severing the AOL, eleven cadaveric specimens were rigged to simulate key pinch. An anteroposterior (AP) radiograph of the hand was recorded for each specimen while intact, after partially opening the joint capsule and after sectioning the AOL. First metacarpal subluxation levels were compared between the intact joint, partially open joint capsule, and sectioned AOL. Neither opening the joint capsule nor cutting the AOL had a statistically significant effect on metacarpal subluxation. The results indicate that partially opening the joint capsule has a negligible effect on joint mechanics and support recent studies that postulate that the AOL plays a less substantial role in preventing subluxation.

scholarly journals Computationally Efficient Magnetic Resonance Imaging Based Surface Contact Modeling as a Tool to Evaluate Joint Injuries and Outcomes of Surgical Interventions Compared to Finite Element Modeling

2014 ◽  
Vol 136 (4) ◽  
Author(s):  
Joshua E. Johnson ◽  
Phil Lee ◽  
Terence E. McIff ◽  
E. Bruce Toby ◽  
Kenneth J. Fischer
Keyword(s):  
Finite Element ◽  
Finite Element Modeling ◽  
Joint Mechanics ◽  
Computationally Efficient ◽  
Efficient Manner ◽  
Element Modeling ◽  
Joint Injuries ◽  
Surface Contact ◽  
Joint Contact ◽  
Contact Pressures

Joint injuries and the resulting posttraumatic osteoarthritis (OA) are a significant problem. There is still a need for tools to evaluate joint injuries, their effect on joint mechanics, and the relationship between altered mechanics and OA. Better understanding of injuries and their relationship to OA may aid in the development or refinement of treatment methods. This may be partially achieved by monitoring changes in joint mechanics that are a direct consequence of injury. Techniques such as image-based finite element modeling can provide in vivo joint mechanics data but can also be laborious and computationally expensive. Alternate modeling techniques that can provide similar results in a computationally efficient manner are an attractive prospect. It is likely possible to estimate risk of OA due to injury from surface contact mechanics data alone. The objective of this study was to compare joint contact mechanics from image-based surface contact modeling (SCM) and finite element modeling (FEM) in normal, injured (scapholunate ligament tear), and surgically repaired radiocarpal joints. Since FEM is accepted as the gold standard to evaluate joint contact stresses, our assumption was that results obtained using this method would accurately represent the true value. Magnetic resonance images (MRI) of the normal, injured, and postoperative wrists of three subjects were acquired when relaxed and during functional grasp. Surface and volumetric models of the radiolunate and radioscaphoid articulations were constructed from the relaxed images for SCM and FEM analyses, respectively. Kinematic boundary conditions were acquired from image registration between the relaxed and grasp images. For the SCM technique, a linear contact relationship was used to estimate contact outcomes based on interactions of the rigid articular surfaces in contact. For FEM, a pressure-overclosure relationship was used to estimate outcomes based on deformable body contact interactions. The SCM technique was able to evaluate variations in contact outcomes arising from scapholunate ligament injury and also the effects of surgical repair, with similar accuracy to the FEM gold standard. At least 80% of contact forces, peak contact pressures, mean contact pressures and contact areas from SCM were within 10 N, 0.5 MPa, 0.2 MPa, and 15 mm2, respectively, of the results from FEM, regardless of the state of the wrist. Depending on the application, the MRI-based SCM technique has the potential to provide clinically relevant subject-specific results in a computationally efficient manner compared to FEM.

Effects of Surgical Repair or Reconstruction on Radiocarpal Mechanics From Wrists With Scapholunate Injury

2011 ◽  
Author(s):  
Joshua E. Johnson ◽  
Sang-Pil Lee ◽  
Terence E. McIff ◽  
E. Bruce Toby ◽  
Kenneth J. Fischer
Keyword(s):  
Contact Forces ◽  
Joint Mechanics ◽  
Imaging Data ◽  
Contact Patterns ◽  
Radiocarpal Joint ◽  
Joint Contact ◽  
Ligament Disruption ◽  
Joint Contact Pressure ◽  
Contact Pressures

Scapholunate dissociation (SL ligament disruption) due to trauma can cause changes in joint kinematics and contact patterns, which can lead to scapholunate advanced collapse (SLAC wrist) with secondary radiocarpal osteoarthritis (OA) [1]. The relationship between consequent abnormal mechanics and the onset of OA is not clearly understood, however elevated joint contact pressure is believed to be an associated factor. Knowing how injuries affect joint physiology and mechanics and how well surgical repairs restore the mechanics may improve surgical efficacy and help predict OA risk. Recently a method was proposed to measure joint contact mechanics from in vivo imaging data during functional loading [2]. The objective of this study was to compare radiocarpal joint mechanics (contact forces, contact areas, peak and average contact pressures) of injured and post-operative wrists to contralateral controls using MRI-based contact modeling. We hypothesized that average contact pressures and peak contact pressures would be higher in the injured wrists, and that these measures would decrease post-operatively.

Can the Hip Joint be Modeled Accurately Using Simplified Geometry?

2008 ◽  
Author(s):  
Andrew E. Anderson ◽  
Steve A. Maas ◽  
Benjamin J. Ellis ◽  
Jeffrey A. Weiss
Keyword(s):  
Contact Pressure ◽  
Hip Joint ◽  
Spherical Geometry ◽  
Model Complexity ◽  
Hip Morphology ◽  
Joint Contact ◽  
Analytical Approaches ◽  
Contact Pressures ◽  
In Vitro Data

Simplified analytical approaches to estimate hip joint contact pressures using perfectly spherical geometry have been described in the literature (rigid body spring models); however, estimations based on these simulations have not corresponded well with experimental in vitro data. Recent evidence from our laboratory suggests that finite element (FE) models of the hip joint that incorporate detailed geometry for cartilage and bone can predict cartilage pressures in good agreement with experimental data [1]. However, it is unknown whether this degree of model complexity is necessary. The objective of this study was to compare cartilage contact pressure predictions from FE models with varying degrees of simplicity to elucidate which aspects of hip morphology are required to obtain accurate predictions of cartilage contact pressure. Models based on 1) subject-specific (SS) geometry, 2) spheres, and 3) rotational conchoids were analyzed.

Assessment of the Effects of Diabetes on Midfoot Joint Pressures Using a Robotic Gait Simulator

2009 ◽  
Vol 30 (8) ◽  
pp. 767-772 ◽  
Author(s):  
Dong Gil Lee ◽  
Brian L. Davis
Keyword(s):  
Stance Phase ◽  
Walking Speed ◽  
Normal Population ◽  
Human Gait ◽  
Diabetic Patients ◽  
Foot Deformity ◽  
Charcot Neuroarthropathy ◽  
Joint Contact ◽  
Peak Pressures ◽  
Contact Pressures

Background: One of the more serious diabetic complications is Charcot neuroarthropathy (CN), a disease that results in arch collapse and permanent foot deformity. However, very little is known about the etiology of CN. From a mechanical standpoint, it is likely that there is a “vicious circle” in terms of (i) arch collapse causing increased midfoot joint pressures, and (ii) increased joint contact pressures exacerbating the collapse of midfoot bones. This study focused on assessment of peak joint pressure difference between diabetic and non-diabetic cadaver feet during simulated walking. We hypothesized that joint pressures are higher for diabetics than normal population. Materials and Methods: Sixteen cadaver foot specimens (eight control and eight diabetic specimens) were used in this study. Human gait at 25% of typical walking speed (averaged stance duration of 3.2s) was simulated by a custom-designed Universal Musculoskeletal Simulator. Four medial midfoot joint pressures (the first metatarsocuneiform, the medial naviculocuneiform, the middle naviculocuneiform, and the first intercuneiform) were measured dynamically during full stance. Results: The pressures in each of the four measured midfoot joints were significantly greater in the diabetic feet ( p = 0.015, p = 0.025, p < 0.001, and p = 0.545, respectively). Conclusion: Across all four tested joints, the diabetic cadaver specimens had, on average, 46% higher peak pressures than the control cadaver feet during the simulated stance phase. Clinical Relevance: This finding suggests that diabetic patients could be predisposed to arch collapse even before there are visible signs of bone or joint abnormalities.

scholarly journals Biomechanics of a novel extra-articular implant for younger patients with knee osteoarthritis

2018 ◽  
Vol 4 (1) ◽  
pp. 203-205
Author(s):  
Mehdi Saeidi ◽  
Maziar Ramezani ◽  
Piaras Kelly ◽  
Mohd Sabri Hussin ◽  
Thomas Neitzert
Keyword(s):  
Knee Joint ◽  
Cartilage Regeneration ◽  
Stress Distributions ◽  
Element Analysis ◽  
Medial Side ◽  
Pressure Distributions ◽  
Joint Contact ◽  
As Stress ◽  
Joint Contact Pressure ◽  
Contact Pressures

AbstractThis research aimed to study the efficacy of a novel implant for osteoarthritic knees. This implant is designed to eliminate excessive loads through the knee and to provide suitable conditions for possible tibiofemoral cartilage regeneration. The implant was designed for the medial side of the knee joint. Finite Element Analysis (FEA) was performed for an extended knee position of the knee joint. Contact pressure distributions on the medial and lateral compartments were investigated as well as stress distributions throughout the implant’s plates. Results with and without the implant were compared, and it was seen that the contact pressures on the surface of the distal femur were reduced by more than 90% after the introduction of the implant.

scholarly journals Immediate Effects of Medially Posted Insoles on Lower Limb Joint Contact Forces in Adult Acquired Flatfoot: A Pilot Study

2020 ◽  
Vol 17 (7) ◽  
pp. 2226 ◽  
Author(s):  
Yinghu Peng ◽  
Duo Wai-Chi Wong ◽  
Yan Wang ◽  
Tony Lin-Wei Chen ◽  
Qitao Tan ◽  
...  
Keyword(s):  
Contact Force ◽  
Lower Limb ◽  
Random Order ◽  
Contact Forces ◽  
Knee Adduction Moment ◽  
Joint Mechanics ◽  
Joint Force ◽  
Ankle Eversion ◽  
Peak Knee ◽  
Joint Contact

Flatfoot is linked to secondary lower limb joint problems, such as patellofemoral pain. This study aimed to investigate the influence of medial posting insoles on the joint mechanics of the lower extremity in adults with flatfoot. Gait analysis was performed on fifteen young adults with flatfoot under two conditions: walking with shoes and foot orthoses (WSFO), and walking with shoes (WS) in random order. The data collected by a vicon system were used to drive the musculoskeletal model to estimate the hip, patellofemoral, ankle, medial and lateral tibiofemoral joint contact forces. The joint contact forces in WSFO and WS conditions were compared. Compared to the WS group, the second peak patellofemoral contact force (p < 0.05) and the peak ankle contact force (p < 0.05) were significantly lower in the WSFO group by 10.2% and 6.8%, respectively. The foot orthosis significantly reduced the peak ankle eversion angle (p < 0.05) and ankle eversion moment (p < 0.05); however, the peak knee adduction moment increased (p < 0.05). The reduction in the patellofemoral joint force and ankle contact force could potentially inhibit flatfoot-induced lower limb joint problems, despite a greater knee adduction moment.

scholarly journals Efficacy of Dorsoradial Capsulodesis for Trapeziometacarpal Joint Instability: A Cadaver Study

2017 ◽  
Vol 42 (1) ◽  
pp. e25-e31 ◽  
Author(s):  
Brian A. Chenoweth ◽  
Gavin D. O'Mahony ◽  
Casey Fitzgerald ◽  
Julie A. Stoner ◽  
Daniel L. O'Donoghue ◽  
...  
Keyword(s):  
Joint Instability ◽  
Cadaver Study ◽  
Trapeziometacarpal Joint

The role of the posterior bundle of the medial collateral ligament in posteromedial rotatory instability of the elbow

2018 ◽  
Vol 100-B (8) ◽  
pp. 1060-1065 ◽  
Author(s):  
J-T. Hwang ◽  
M. N. Shields ◽  
L. J. Berglund ◽  
A. W. Hooke ◽  
J. S. Fitzsimmons ◽  
...  
Keyword(s):  
Contact Pressure ◽  
Medial Collateral Ligament ◽  
Lateral Collateral Ligament ◽  
Collateral Ligament ◽  
Coronoid Fracture ◽  
Rotatory Instability ◽  
Intact Group ◽  
Joint Contact ◽  
The Mean ◽  
Contact Pressures

Aims The aim of this study was to evaluate two hypotheses. First, that disruption of posterior bundle of the medial collateral ligament (PMCL) has to occur for the elbow to subluxate in cases of posteromedial rotatory instability (PMRI) and second, that ulnohumeral contact pressures increase after disruption of the PMCL. Materials and Methods Six human cadaveric elbows were prepared on a custom-designed apparatus which allowed muscle loading and passive elbow motion under gravitational varus. Joint contact pressures were measured sequentially in the intact elbow (INTACT), followed by an anteromedial subtype two coronoid fracture (COR), a lateral collateral ligament (LCL) tear (COR + LCL), and a PMCL tear (COR + LCL + PMCL). Results There was no subluxation or joint incongruity in the INTACT, COR, and COR + LCL specimens. All specimens in the COR + LCL + PMCL group subluxated under gravity-varus loads. The mean articular contact pressure of the COR + LCL group was significantly higher than those in the INTACT and the COR groups. The mean articular contact pressure of the COR + LCL + PMCL group was significantly higher than that of the INTACT group, but not higher than that of the COR + LCL group. Conclusion In the presence of an anteromedial fracture and disruption of the LCL, the posterior bundle of the MCL has to be disrupted for gross subluxation of the elbow to occur. However, elevated joint contact pressures are seen after an anteromedial fracture and LCL disruption even in the absence of such subluxation. Cite this article: Bone Joint J 2018;100-B:1060–5.

Effects of Inserting a Pressensor Film Into Articular Joints on the Actual Contact Mechanics

1998 ◽  
Vol 120 (5) ◽  
pp. 655-659 ◽  
Author(s):  
J. Z. Wu ◽  
W. Herzog ◽  
M. Epstein
Keyword(s):  
Contact Mechanics ◽  
Solid Phase ◽  
Elastic Solid ◽  
Fluid Phase ◽  
Measurement Precision ◽  
Inviscid Fluid ◽  
Articular Joint ◽  
Joint Contact ◽  
Contact Pressures ◽  
Fuji Film

Fuji film has been widely used in studies aimed at obtaining the contact mechanics of articular joints. Once sealed for practical use in biological joints, Fuji Pressensor film has a total effective thickness of 0.30 mm, which is comparable to the cartilage thickness in the joints of many small animals. The average effective elastic modulus of Fuji film is approximately 100 MPa in compression, which is larger by a factor of 100–300 compared to that of normal articular cartilage. Therefore, inserting a Pressensor film into an articular joint will change the contact mechanics of the joint. The measurement precision of the Pressensor film has been determined systematically; however, the changes in contact mechanics associated with inserting the film into joints have not been investigated. This study was aimed at quantifying the changes in the contact mechanics associated with inserting sealed Fuji Pressensor film into joints. Spherical and cylindrical articular joint contact mechanics with and without Pressensor film and for varying degrees of surface congruency were analyzed and compared by using finite element models. The Pressensor film was taken as linearly elastic and the cartilage was assumed to be biphasic, composed of a linear elastic solid phase and an inviscid fluid phase. The present analyses showed that measurements of the joint contact pressures with Fuji Pressensor film will change the maximum true contact pressures by 10–26 percent depending on the loading, geometry of the joints, and the mechanical properties of cartilage. Considering this effect plus the measurement precision of the film (approximately 10 percent), the measured joint contact pressures in a joint may contain errors as large as 14–28 percent.

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