Comparison of Normal Capitate Mid-Carpal Joint Mechanics With the Effects of Scapholunate Dissociation Injury

2011 ◽  
Author(s):  
Madhan Sai Kallem ◽  
Sang-Pil Lee ◽  
Terence E. McIff ◽  
E. Bruce Toby ◽  
Kenneth J. Fischer
Keyword(s):  
Contact Mechanics ◽  
Surgical Techniques ◽  
Ligament Injury ◽  
Joint Mechanics ◽  
Scapholunate Dissociation ◽  
Carpal Collapse ◽  
Contact Patterns ◽  
Carpal Joint ◽  
Slac Wrist

The wrist is one of the most complicated multibody joints in the human body. It can be subject to many injuries. Scapholunate (SL) dissociation is a relatively common injury that is particularly difficult to diagnose and treat. Without treatment, SL dissociation is known to progress to scapholunate advance collapse (SLAC wrist) and associated osteoarthritis (OA) [1]. Traumatic arthropathy of the wrist due to scapholunate dissociation has a definitive pattern from onset to severe bone and joint degeneration. The altered radiocarpal and SL mechanics with SL dissociation may be accompanied by a secondary carpal collapse between the capitate and lunate [2]. The initial SL disruption causes apparent changes in joint kinematics and contact patterns. Thus, understanding normal and abnormal in vivo contact mechanics as a result of SL ligament injury may lead to more effective treatments that may even prevent the onset of OA. In addition, in vivo contact mechanics data after surgical treatment may help determine the effectiveness of various surgical techniques which are used to correct SL injury.

Finite Element Analysis of In Vivo Radiocarpal Contact Mechanics Resulting From Scapholunate Ligament Injury

2012 ◽  
Author(s):  
Joshua E. Johnson ◽  
Phil Lee ◽  
Terence E. McIff ◽  
E. Bruce Toby ◽  
Kenneth J. Fischer
Keyword(s):  
Finite Element ◽  
Contact Mechanics ◽  
Contact Forces ◽  
Computational Method ◽  
Ligament Injury ◽  
Joint Mechanics ◽  
Interosseous Ligament ◽  
Radiocarpal Joint ◽  
Contact Pressures

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.

In Vivo Contact Mechanics of the Distal Radioulnar Joint of the Normal Wrist Compared to Scapholunate Injury and Surgical Repair

2011 ◽  
Author(s):  
Mathew S. Varre ◽  
Sang-Pil Lee ◽  
Terence E. McIff ◽  
E. Bruce Toby ◽  
Kenneth J. Fischer
Keyword(s):  
Contact Mechanics ◽  
Distal Radioulnar Joint ◽  
The Body ◽  
Ulnar Variance ◽  
Joint Mechanics ◽  
Force Transmission ◽  
Scapholunate Dissociation ◽  
Secondary Osteoarthritis ◽  
Radioulnar Joint

The distal radioulnar joint (DRUJ) is a joint of the wrist which allows forearm rotation and force transmission in the upper limb while preserving stability independent of flexion and extension of the forearm and wrist. The DRUJ is a frequently injured joint in the body. Conditions affecting the joint could be positive ulnar variance (Ulnar Impaction Syndrome) or negative ulnar variance (ulnar impingement), which may be congenital or may result from a poorly reduced distal radius fracture or both bone forearm fracture. The DRUJ is also adversely affected by other injuries near the joint. In fact, a significant correlation has been found between negative ulnar variance and scapholunate dissociation [1, 2, 3]. While this could be a predisposing factor, the associate also leads to the question of whether or not scapholunate dissociation may cause changes in the radioulnar joint mechanics. Altered joint mechanics are highly associated with onset of secondary osteoarthritis. An understanding of in vivo distal radioulnar joint contact mechanics in the normal and pathological wrist could help physicians make better clinical recommendations and improve treatment for the primary injury and avoid DRUJ pathology. Successful treatment may possibly reduce risk of or prevent the onset of osteoarthritis.

Evaluation of Wrist Cartilage With and Without Scapholunate Ligament Injury in Pre and Post Operation Subjects

2011 ◽  
Author(s):  
Dannica L. Sturgeon ◽  
Sang-Pil Lee ◽  
Terence E. McIff ◽  
E. Bruce Toby ◽  
Kenneth J. Fischer
Keyword(s):  
Positive Impact ◽  
Ligament Injury ◽  
Wrist Injuries ◽  
Scapholunate Ligament ◽  
Scapholunate Dissociation ◽  
Scapholunate Ligament Injury ◽  
Assessment And Treatment ◽  
Post Operation ◽  
Slac Wrist

Hand and wrist injuries commonly occur and can be debilitating. Scapholunate dissociation generally requires surgery, and if left untreated, can lead to scapholunate advanced collapse (SLAC wrist) and associated osteoarthritis [1]. The overall goal of this research is to make a positive impact on the assessment and treatment of wrist injuries and on prevention of osteoarthritis as a result of injury.

scholarly journals Scapholunate ligament injury adversely alters in vivo wrist joint mechanics: An MRI-based modeling study

2013 ◽  
Vol 31 (9) ◽  
pp. 1455-1460 ◽  
Author(s):  
Joshua E. Johnson ◽  
Phil Lee ◽  
Terence E. McIff ◽  
E. Bruce Toby ◽  
Kenneth J. Fischer
Keyword(s):  
Wrist Joint ◽  
Ligament Injury ◽  
Joint Mechanics ◽  
Scapholunate Ligament ◽  
Scapholunate Ligament Injury ◽  
Modeling Study

Changes in Glenohumeral Joint Mechanics, Shoulder Strength, and Clinical Outcomes Over Two Years After Rotator Cuff Repair

2009 ◽  
Author(s):  
Michael J. Bey ◽  
Stephanie K. Kline ◽  
Jessica M. Deneweth ◽  
Jeffrey R. Haladik ◽  
Patricia A. Kolowich ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
Glenohumeral Joint ◽  
Rotator Cuff Tears ◽  
Joint Mechanics ◽  
Medical Care Costs ◽  
Contact Patterns ◽  
Shoulder Strength ◽  
Cuff Repair

Rotator cuff tears are a common injury that have a major impact on function, comfort, and medical care costs. Treatment procedures rely implicitly on the belief that restoring normal glenohumeral joint (GHJ) mechanics is necessary to obtain a satisfactory clinical result. However, it is unknown if rotator cuff repair restores and maintains normal GHJ mechanics. Thus, the objective of this study was to compare in-vivo GHJ contact patterns between the repaired and contralateral shoulders of patients who underwent rotator cuff repair. We hypothesized that GHJ contact patterns would be significantly different between repaired and contralateral shoulders.

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.

Development and Verification of a Dynamic TKR Model

2002 ◽  
Author(s):  
Jason P. Halloran ◽  
Anthony J. Petrella ◽  
Paul J. Rullkoetter
Keyword(s):  
Finite Element ◽  
Contact Mechanics ◽  
Dynamic Loading ◽  
Soft Tissues ◽  
Dynamic Models ◽  
Total Joint Replacement ◽  
Fe Model ◽  
Loading Conditions ◽  
Dynamic Loading Conditions

The success of current total knee replacement (TKR) devices is contingent on the kinematics and contact mechanics during in vivo activity. Indicators of potential clinical performance of total joint replacement devices include contact stress and area due to articulations, and tibio-femoral and patello-femoral kinematics. An effective way of evaluating these parameters during the design phase or before clinical use is via computationally efficient computer models. Previous finite element (FE) knee models have generally been used to determine contact stresses and/or areas during static or quasi-static loading conditions. The majority of knee models intended to predict relative kinematics have not been able to determine contact mechanics simultaneously. Recently, however, explicit dynamic finite element methods have been used to develop dynamic models of TKR able to efficiently determine joint and contact mechanics during dynamic loading conditions [1,2]. The objective of this research was to develop and validate an explicit FE model of a TKR which includes tibio-femoral and patello-femoral articulations and surrounding soft tissues. The six degree-of-freedom kinematics, kinetics and polyethylene contact mechanics during dynamic loading conditions were then predicted during gait simulation.

scholarly journals Alterations in articular cartilage T2 star relaxation time following mechanical disorders: in vivo canine supraspinatus tendon resection models

2020 ◽  
Author(s):  
Dokwan Lee ◽  
Ki-Taek Hong ◽  
Tae Seong Lim ◽  
Eugene Lee ◽  
Ye Hyun Lee ◽  
...  
Keyword(s):  
Relaxation Time ◽  
Articular Cartilage ◽  
Motion Tracking ◽  
Supraspinatus Tendon ◽  
Quantitative Mri ◽  
Joint Mechanics ◽  
T2 Relaxation Time ◽  
T2 Relaxation ◽  
Positive Correlations

Abstract Background: The role of altered joint mechanics on cartilage degeneration in in vivo models has not been studied successfully due to a lack of pre-injury information. We aimed 1) to develop an accurate in vivo canine model to measure the changes in joint loading and T2 star (T2*) relaxation time before and after unilateral supraspinatus tendon resections, and 2) to find the relationship between regional variations in articular cartilage loading patterns and T2* relaxation time distributions.Methods: Rigid markers were implanted in the scapula and humerus of tested dogs. The movement of the shoulder bones were measured by a motion tracking system during normal gaits. In vivo cartilage contact strain was measured by aligning 3D shoulder models with the motion tracking data. Articular cartilage T2* relaxation times were measured by quantitative MRI scans. Articular cartilage contact strain and T2* relaxation time were compared in the shoulders before and three months after the supraspinatus tendon resections.Results: Excellent accuracy and reproducibility were found in our in vivo contact strain measurements with less than 1% errors. Changes in articular cartilage contact strain exhibited similar patterns with the changes in the T2* relaxation time after resection surgeries. Regional changes in the articular cartilage T2* relaxation time exhibited positive correlations with regional contact strain variations three months after the supraspinatus resection surgeries.Conclusion: This is the first study to measure in vivo articular cartilage contact strains with high accuracy and reproducibility. Positive correlations between contact strain and T2* relaxation time suggest that the articular cartilage extracellular matrix may responds to mechanical changes in local areas.

scholarly journals EVALUATION OF A TRAINING COURSE ON OPEN VASCULAR SURGICAL TECHNIQUES IN AORTOILIAC PATHOLOGY - 5 YEARS OF EXPERIENCE

2015 ◽  
Vol 88 (2) ◽  
pp. 196-202
Author(s):  
Bogdan Stancu ◽  
Florin Beteg ◽  
Aurel Mironiuc ◽  
Aurel Muste ◽  
Claudia Gherman
Keyword(s):  
Surgical Technique ◽  
Vascular Surgery ◽  
Prospective Study ◽  
Surgical Techniques ◽  
Surgical Skills ◽  
Technical Quality ◽  
Statistical Association ◽  
Abdominal Aortic

Introduction. The aim of this prospective study was to assess the efficacy of a vascular surgery course (2008-2012), and to verify the viability and the feasibility of the vascular anastomoses.Material and method. Vascular surgical techniques performed simultaneously on pigs were: enlargement prosthetic angioplasty, abdominal aortic interposition graft and aortoiliac bypass. Endpoints of the study were the surgical skills and the technical quality, evaluated on a scale ranging from 1 (satisfactory) to 3 (very good) for our participants.Result. A significant improvement in vascular surgical skills tasks was observed during the study years and we also found a semnificative statistical association between the quality of suture and the surgical technique used (Kendall coefficient=0.71, p=0.001<0.05).Conclusions. Our course contributed to the improvement of technical vascular surgical skills of the operator teams, reproducing in vivo, in pigs, the intraoperative environment as in human patients.

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