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

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Abstract

Osteoarthritis as a result of injury/trauma is a significant problem, and there is still a need to develop tools for evaluating joint injuries and the effectiveness of surgical treatments. For the wrist in particular, injury to the scapholunate ligament from impact loading, can lead to scapholunate joint instability. Without treatment, this can lead to progressive development of wrist osteoarthritis. Joint contact pressures are important mechanical factors in the etiology of osteoarthritis, and these can be determined non-invasively through computer modeling. Hence, the goal of this work was to investigate the effects of scapholunate ligament injury and surgical repair on radioscapholunate contact mechanics, through surface contact modeling (SCM) and finite element modeling (FEM). The modeling process required geometries, boundary conditions and a contact relationship. Magnetic resonance imaging (MRI) was used to acquire images of the normal, injured and post-operative wrists, while relaxed and during active grasp loading. Surface and volumetric models were generated from the relaxed images, while kinematic boundary conditions were determined from image registration between the relaxed and loaded images. To improve the automatic image registration process, the effects of initial manual registration on the outcome of final registration accuracy, were investigated. Results showed that kinematic accuracy and subsequent contact mechanics were improved by performing a manual registration to align the image volumes as close as possible, before auto-registration. Looking at the effects of scapholunate ligament injury, results showed that contact forces, contact areas, peak and mean contact pressures significantly increased in the radioscaphoid joint. The locations of contact also shifted with injury. This novel data showed that contact mechanics was altered for the worse after injury. Novel contact mechanics data on the effects of surgical repair were also obtained. Results showed that radiolunate peak and mean contact pressures decreased significantly compared to injured, which indicated the possibility of restoring normal mechanics post surgery. SCM results were compared to FEM results to demonstrate the feasibility of the surface contact modeling approach for clinical applications. Contact parameters compared well between the two techniques. This work demonstrated the potential of MRI-based SCM as a tool to evaluate joint injuries and subsequent treatments, for clinical applications.

Cited Works (14)

Year	Entry
2000	Eckstein F, Lemberger B, Stammberger T, Englmeier KH, Reiser M. Patellar cartilage deformation in vivo after static versus dynamic loading. J Biomech. July 2000;33(7):819-825.
2007	Blemker SS, Asakawa DS, Gold GE, Delp SL. Image-based musculoskeletal modeling: applications, advances, and future opportunities. J Magn Reson Imaging. February 2007;25(2):441-451.
2009	Varga P, Baumbach S, Pahr D, Zysset PK. Validation of an anatomy specific finite element model of Colles’ fracture. J Biomech. August 7, 2009;42(11):1726-1731.
1997	Jurvelin JS, Buschmann MD, Hunziker EB. Optical and mechanical determination of Poisson's ratio of adult bovine humeral articular cartilage. J Biomech. March 1997;30(3):235-241.
2005	Anderson AE, Peters CL, Tuttle BD, Weiss JA. Subject-specific finite element model of the pelvis: development, validation and sensitivity studies. J Biomech Eng. June 2005;127(3):365-373.
2004	Carter DR, Beaupré GS, Wong M, Smith RL, Andriacchi TP, Schurman DJ. The mechanobiology of articular cartilage development and degeneration. Clin Orthop Relat Res. October 2004;427(suppl):S69-S77.
2008	Lawrence RC, Felson DT, Helmick CG, Arnold LM, Choi H, Deyo RA, Gabriel S, Hirsch R, Hochberg MC, Hunder GG, Jordan JM, Katz JN, Kremers HM, Wolfe F; National Arthritis Data Workgroup. Estimates of the prevalence of arthritis and other rheumatic conditions in the United States: part II. Arthritis Rheum. January 2008;58(1):26-35.
2006	Andriacchi TP, Briant PL, Bevill SL, Koo S. Rotational changes at the knee after ACL injury cause cartilage thinning. Clin Orthop Relat Res. January 2006;442:39-44.
2004	Andriacchi TP, Mündermann A, Smith RL, Alexander EJ, Dyrby CO, Koo S. A framework for the in vivo pathomechanics of osteoarthritis at the knee. Ann Biomed Eng. March 2004;32(3):447-457.
2008	Anderson AE, Ellis BJ, Maas SA, Peters CL, Weiss JA. Validation of finite element predictions of cartilage contact pressure in the human hip joint. J Biomech Eng. October 2008;130(5):051008.
2008	Chaudhari AMW, Briant PL, Bevill SL, Koo S, Andriacchi TP. Knee kinematics, cartilage morphology, and osteoarthritis after ACL injury. Med Sci Sports Exer. February 2008;40(2):215-222.
2002	Korhonen RK, Laasanen MS, Töyräs J, Rieppo J, Hirvonen J, Helminen HJ, Jurvelin JS. Comparison of the equilibrium response of articular cartilage in unconfined compression, confined compression and indentation. J Biomech. July 2002;35(7):903-909.
2009	Andriacchi TP, Koo S, Scanlan SF. Gait mechanics influence healthy cartilage morphology and osteoarthritis of the knee. J Bone Joint Surg. February 2009;91A(suppl 1):95-101.
2011	Anderson DD, Chubinskaya S, Guilak F, Martin JA, Oegema TR, Olson SA, Buckwalter JA. Post-traumatic osteoarthritis: improved understanding and opportunities for early intervention. J Orthop Res. June 2011;29(6):802-809.