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

Author(s):  
Joshua E. Johnson ◽  
Sang-Pil Lee ◽  
Terence E. McIff ◽  
E. Bruce Toby ◽  
Kenneth J. Fischer

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.

Author(s):  
Joshua E. Johnson ◽  
Phil Lee ◽  
Terence E. McIff ◽  
E. Bruce Toby ◽  
Kenneth J. Fischer

Secondary osteoarthritis (OA) as a result of joint injury is a significant problem. For the wrist in particular, scapholunate dissociation, resulting from injury to the scapholunate interosseous ligament (SLIL), is a commonly occurring pathology. SLIL tears can lead to scapholunate joint instability due to abnormal motion and load transfer through multiple carpal joints. If left untreated, SLIL injury has been known to progress to scapholunate advanced collapse (or SLAC wrist) with radiocarpal OA [1]. While the pathomechanics leading to the onset of OA are not clearly understood, changes in kinematics and contact mechanics with injury are believed to be causative factors. Of particular importance are joint contact pressures and pressure distributions, which are considered to be important mechanical factors. Comparing changes in joint mechanics between normal and injured wrists may help us better understand the progression of OA and improve the efficacy of corrective measures. Several techniques exist to evaluate joint mechanics. Of these, 3D image-based computational modeling is very useful to determine in vivo joint mechanics. Finite element modeling (FEM) is the most common and widely used computational method because of the ability to obtain 3D stresses and strains, and due to software availability. Therefore the objective of this study was to compare radiocarpal joint mechanics (contact forces, contact areas, contact locations, peak and average contact pressures) from FEM between normal and injured wrists. We hypothesized that peak contact pressures and average contact pressures would be higher in the injured wrists.


2000 ◽  
Vol 04 (01) ◽  
pp. 1-7 ◽  
Author(s):  
W. Herzog ◽  
E. M. Hasler ◽  
T. R. Leonard

The purpose of this communication is to present an idea, and its technical implementation, on how to estimate experimentally in vivo joint contact pressure distributions. The idea is illustrated for the cat patellofemoral joint. For this particular joint, the approach requires muscle force and hindlimb movement measurements during unrestrained locomotion, and the quantification of the joint contact pressures in situ for conditions approximating the in vivo conditions as closely as possible. Although the approach is time-consuming and has its limitations, it is, as far as we know, the first purely experimental approach to determine the in vivo joint contact pressures during normal movement. "Purely experimental" refers to the idea that the required movements, muscle forces and contact pressures are all measured rather than estimated theoretically.


2014 ◽  
Vol 136 (2) ◽  
Author(s):  
Darryl G. Thelen ◽  
Kwang Won Choi ◽  
Anne M. Schmitz

This study introduces a framework for co-simulating neuromuscular dynamics and knee joint mechanics during gait. A knee model was developed that included 17 ligament bundles and a representation of the distributed contact between a femoral component and tibial insert surface. The knee was incorporated into a forward dynamics musculoskeletal model of the lower extremity. A computed muscle control algorithm was then used to modulate the muscle excitations to drive the model to closely track measured hip, knee, and ankle angle trajectories of a subject walking overground with an instrumented knee replacement. The resulting simulations predicted the muscle forces, ligament forces, secondary knee kinematics, and tibiofemoral contact loads. Model-predicted tibiofemoral contact forces were of comparable magnitudes to experimental measurements, with peak medial (1.95 body weight (BW)) and total (2.76 BW) contact forces within 4–17% of measured values. Average root-mean-square errors over a gait cycle were 0.26, 0.42, and 0.51 BW for the medial, lateral, and total contact forces, respectively. The model was subsequently used to predict variations in joint contact pressure that could arise by altering the frontal plane joint alignment. Small variations (±2 deg) in the alignment of the femoral component and tibial insert did not substantially affect the location of contact pressure, but did alter the medio-lateral distribution of load and internal tibia rotation in swing. Thus, the computational framework can be used to virtually assess the coupled influence of both physiological and design factors on in vivo joint mechanics and performance.


Author(s):  
George Papaioannou ◽  
William Anderst ◽  
Scott Tashman

Assessment of in vivo human cartilage loading generally requires computer modeling, since loads usually cannot be directly measured. The utility of these models for assessing knee behavior during complex activities has been limited by the relatively poor quality of experimental data on in vivo knee function. We have developed a method combining high-accuracy knee kinematics (from high-speed stereo-radiography) with subject-specific finite-element models to estimate in vivo cartilage contact pressures during stressful tasks. When applied to ACL reconstruction, significantly higher contact pressures were found in reconstructed knees as compared to the contralateral (uninjured) knees of the same individuals.


2014 ◽  
Vol 136 (4) ◽  
Author(s):  
Joshua E. Johnson ◽  
Phil Lee ◽  
Terence E. McIff ◽  
E. Bruce Toby ◽  
Kenneth J. Fischer

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.


2018 ◽  
Vol 4 (1) ◽  
pp. 203-205
Author(s):  
Mehdi Saeidi ◽  
Maziar Ramezani ◽  
Piaras Kelly ◽  
Mohd Sabri Hussin ◽  
Thomas Neitzert

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.


Author(s):  
Yinghu Peng ◽  
Duo Wai-Chi Wong ◽  
Yan Wang ◽  
Tony Lin-Wei Chen ◽  
Qitao Tan ◽  
...  

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.


Author(s):  
Hannah J. Lundberg ◽  
Markus A. Wimmer

Detailed knowledge of in vivo knee contact forces and the contribution from muscles, ligaments, and other soft-tissues to knee joint function are essential for evaluating total knee replacement (TKR) designs. We have recently developed a mathematical model for calculating knee joint contact forces using parametric methodology (Lundberg et al., 2009). The numerical model calculates a “solution space” of three-dimensional contact forces for both the medial and lateral compartments of the tibial plateau. The solution spaces are physiologically meaningful, and represent the result of balancing the external moments and forces by different strategies.


Author(s):  
Hannah J. Lundberg ◽  
Christopher B. Knowlton ◽  
Diego Orozco ◽  
Markus A. Wimmer

Knowledge of in vivo knee contact forces is essential for evaluating total knee replacement (TKR) designs. This is particularly true for activities other than walking, because there is still a limited understanding of its impact on wear. It has been shown that wear scars from retrieved implants have obvious differences compared with simulator tested components in both size of worn area and in damage mode. The divergence could be related to the omission of other activities than walking when testing components in the simulator. The purpose of this study was to use a parametric numerical model for predicting joint contact forces during stair ascent/descent and chair sitting/rising and compare those to measured forces from a database. We hypothesized that the contact force output of the numeric model would be similar to the measured forces.


Author(s):  
Justin W. Fernandez ◽  
Hyung J. Kim ◽  
Massoud Akbarshahi ◽  
Jonathan P. Walter ◽  
Benjamin J. Fregly ◽  
...  

Many studies have used musculoskeletal models to predict in vivo muscle forces at the knee during gait [1, 2]. Unfortunately, quantitative assessment of the model calculations is often impracticable. Various indirect methods have been used to evaluate the accuracy of model predictions, including comparisons against measurements of muscle activity, joint kinematics, ground reaction forces, and joint moments. In a recent study, an instrumented hip implant was used to validate calculations of hip contact forces directly [3]. The same model was subsequently used to validate model calculations of tibiofemoral loading during gait [4]. Instrumented knee implants have also been used in in vitro and in vivo studies to quantify differences in biomechanical performance between various TKR designs [5, 6]. The main aim of the present study was to evaluate model predictions of knee muscle forces by direct comparison with measurements obtained from an instrumented knee implant. Calculations of muscle and joint-contact loading were performed for level walking at slow, normal, and fast speeds.


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