scholarly journals A four-dimensional-CT study of in vivo scapholunate rotation axes: possible implications for scapholunate ligament reconstruction

2019 ◽  
Vol 44 (5) ◽  
pp. 479-487 ◽  
Author(s):  
Marieke G. A. de Roo ◽  
Marijn Muurling ◽  
Johannes G. G. Dobbe ◽  
Michelle E. Brinkhorst ◽  
Geert J. Streekstra ◽  
...  
Keyword(s):  
Ligament Reconstruction ◽  
Rotation Axis ◽  
Optimal Location ◽  
Long Term Results ◽  
Proximal Pole ◽  
Scapholunate Ligament ◽  
Interosseous Ligament ◽  
Flexion Extension ◽  
Dorsal Ridge

Additional fixation of the palmar scapholunate interosseous ligament has been advocated to improve the long-term results of dorsal scapholunate interosseous ligament reconstruction. To investigate the validity of this approach, we determined normal scapholunate motion patterns and calculated the location of the scapholunate rotation axis. We hypothesized that the optimal location of the scapholunate interosseous ligament insertion could be determined from the scapholunate rotation axis. Four-dimensional computerized tomography was used to study the wrist motion in 21 healthy participants. During flexion–extension motions, the scaphoid rotates 38° (SD 0.6°) relative to the lunate; the rotation axis intersects the dorsal ridge of the proximal pole of the scaphoid and the dorsal ridge of the lunate. Minimal scapholunate motion is present during radioulnar deviation. Since the scapholunate rotation axis runs through the dorsal proximal pole of the scaphoid, this is probably the optimal location for attaching the scapholunate ligament during reconstructive surgery.

scholarly journals Kinematic analysis of two scapholunate ligament reconstruction techniques

2021 ◽  
Vol 29 (2) ◽  
pp. 230949902110258
Author(s):  
Seungbum Chae ◽  
Junho Nam ◽  
Il-Jung Park ◽  
Steven S. Shin ◽  
Michelle H. McGarry ◽  
...  
Keyword(s):  
Kinematic Analysis ◽  
Clinical Relevance ◽  
Ligament Reconstruction ◽  
Operative Time ◽  
Efficient Technique ◽  
Scapholunate Ligament ◽  
Interosseous Ligament ◽  
Flexion Extension

Purpose: This study compares the kinematic changes after the procedures for scapholunate interosseous ligament (SLIL) reconstruction—the modified Brunelli technique (MBT) and Mark Henry’s technique (MHT). Methods: Ten cadaveric wrists were used. The scapholunate (SL) interval and angle and radiolunate (RL) angle were recorded using the MicroScribe system. The SL interval was measured by dividing the volar and dorsal portions. Four motions of the wrist were performed—neutral, flexion, extension, and clenched fist (CF) positions—and compared among five conditions: (1) intact wrist, (2) volar SLIL resection, (3) whole SLIL resection, (4) MBT reconstruction, and (5) MHT reconstruction. Results: Under the whole SLIL resection condition, the dorsal SL intervals were widened in all positions. In all positions, the dorsal SL intervals were restored after MBT and MHT. The volar SL interval widened in the extension position after volar SLIL resection. The volar SL interval was not restored in the extension position after MBT and MHT. The SL angle increased in the neutral and CF positions under the whole SLIL resection condition. The SL angle was not restored in the neutral and CF positions after MBT and MHT. The RL angle increased in the neutral and CF positions under the whole SLIL resection condition. The RL angle was not restored in the neutral and CF positions after MBT and MHT. Conclusion: The MBT and MHT may restore the dorsal SL interval. No significant differences in restoration of the SL interval between MBT and MHT were found in the cadaveric models. Clinical relevance: No significant differences between MBT and MHT were found in the cadaveric models for SLIL reconstruction. When considering the complications due to volar incision and additional procedures in MHT, MBT may be a more efficient technique in terms of operative time and injury of the anterior structures during surgery, but further research is needed.

scholarly journals ASSESSMENT of bIoresorbable Screws and bone tissue in long-term period after the anterior cruciate ligament reconstruction

2016 ◽  
Vol 7 (4) ◽  
pp. 3-8
Author(s):  
E A Zvezdkina ◽  
V N Lesnyak ◽  
A A Akhpashev ◽  
E A Dzhambinova ◽  
A S Kanaev
Keyword(s):  
Anterior Cruciate Ligament ◽  
Anterior Cruciate Ligament Reconstruction ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Single Point ◽  
Long Term Results ◽  
Cruciate Ligament Reconstruction ◽  
Anterior Cruciate

The use of bioresorbable materials in the anterior cruciate ligament reconstruction is a promising direction. Thus today there is no single point of view on the long-term results of using absorbable interference screws. The article presents an analysis of the results of surgical treatment of 30 patients with use of bioresorbable materials, operated on for rupture of the anterior cruciate ligament (ACL) in the department of traumatology and orthopedics from 2010 to 2016 in the Federal Scientific Clinical Center FMBA of Russia. The aim of our study was to evaluate in vivo transformation of bioresorbable screws and bone assimilation into the tibial canal in long-term period after surgery, as well as the effect of the polymeric material and bone on these processes.

scholarly journals Biomechanics of an Articulated Screw in Acute Scapholunate Ligament Disruption

2017 ◽  
Vol 07 (02) ◽  
pp. 101-108
Author(s):  
Corey Schiffman ◽  
Muturi Muriuki ◽  
Robert Havey ◽  
Leonard Voronov ◽  
Randy Bindra ◽  
...  
Keyword(s):  
Screw Fixation ◽  
Screw Loosening ◽  
Scapholunate Ligament ◽  
Interosseous Ligament ◽  
Ulnar Deviation ◽  
Motion Simulator ◽  
Significant Difference ◽  
Flexion Extension ◽  
Physiological Motion ◽  
Ligament Disruption

Background An injury to the scapholunate interosseous ligament (SLIL) leads to instability in the scapholunate joint. Temporary fixation is used to protect the ligament during reconstruction or healing of the repair. Rigid screw fixation—by blocking relative physiological motion between the scaphoid and lunate—can lead to screw loosening, pullout, and fracture. Purpose This study aims to evaluate changes in scaphoid and lunate kinematics following SLIL injury and the effectiveness of an articulating screw at restoring preinjury motion. Materials and Methods The kinematics of the scaphoid and lunate were measured in 10 cadaver wrists through three motions driven by a motion simulator. The specimens were tested intact, immediately following SLIL injury, after subsequent cycling, and after fixation with a screw. Results Significant changes in scaphoid and lunate motion occurred following SLIL injury. Postinjury cycling increased motion changes in flexion-extension and radial-ulnar deviation. The motion was not significantly different from the intact scapholunate joint after placement of the articulating screw. Conclusion In agreement with other studies, sectioning of the SLIL led to significant kinematic changes of the scaphoid and lunate in all motions tested. Compared with intact scapholunate joint, no significant difference in kinematics was found after placement of the screw indicating a correction of some of the changes produced by SLIL transection. These findings suggest that the articulating screw may be effective for protecting a SLIL repair while allowing the physiological rotation to occur between the scaphoid and lunate. Clinical Relevance A less rigid construct, such as the articulating screw, may allow earlier wrist rehabilitation with less screw pullout or failure.

scholarly journals Accuracy and repeatability of wrist joint angles in boxing using an electromagnetic tracking system

2019 ◽  
Vol 23 (1) ◽  
Author(s):  
Ian T. Gatt ◽  
Tom Allen ◽  
Jon Wheat
Keyword(s):  
Wrist Joint ◽  
Tracking System ◽  
Testing Procedure ◽  
Electromagnetic Tracking ◽  
Good Reliability ◽  
Flexion Extension ◽  
In Vivo Testing ◽  
Accuracy And Repeatability ◽  
Electromagnetic Tracking System

AbstractThe hand-wrist region is reported as the most common injury site in boxing. Boxers are at risk due to the amount of wrist motions when impacting training equipment or their opponents, yet we know relatively little about these motions. This paper describes a new method for quantifying wrist motion in boxing using an electromagnetic tracking system. Surrogate testing procedure utilising a polyamide hand and forearm shape, and in vivo testing procedure utilising 29 elite boxers, were used to assess the accuracy and repeatability of the system. 2D kinematic analysis was used to calculate wrist angles using photogrammetry, whilst the data from the electromagnetic tracking system was processed with visual 3D software. The electromagnetic tracking system agreed with the video-based system (paired t tests) in both the surrogate (< 0.2°) and quasi-static testing (< 6°). Both systems showed a good intraclass coefficient of reliability (ICCs > 0.9). In the punch testing, for both repeated jab and hook shots, the electromagnetic tracking system showed good reliability (ICCs > 0.8) and substantial reliability (ICCs > 0.6) for flexion–extension and radial-ulnar deviation angles, respectively. The results indicate that wrist kinematics during punching activities can be measured using an electromagnetic tracking system.

An Interlocking Ligamentous Spinal Disk Arthroplasty with Neural Network Infrastructure

2010 ◽  
Vol 7 ◽  
pp. 55-79 ◽  
Author(s):  
Philip Boughton ◽  
James Merhebi ◽  
C. Kim ◽  
G. Roger ◽  
Ashish D. Diwan ◽  
...  
Keyword(s):  
Neural Network ◽  
Finite Element ◽  
Axial Compression ◽  
Wire Array ◽  
Axial Strain ◽  
Compressive Strain ◽  
Niti Wire ◽  
Motion Segment ◽  
Flexion Extension

An elastomeric spinal disk prosthesis design (BioFI™) with vertebral interlocking anchors has been modified using an embedded TiNi wire array. Bioinert styrenic block copolymer (Kraton®) and polycarbonate urethane (Bionate®) thermoplastic elastomer (TPE) matrices were utilized. Fatigue resistant NiTi wire was pretreated to induce superelastic martensitic microstructure. Stent-like helical structures were produced for incorporation within homogenous TPE matrix. Composite prototypes were fabricated in a vacuum hot press using transfer moulding techniques. Implant prototypes were subject to axial compression using a BOSE ® ELF3400. The NiTi reinforced implants exhibited reduction in axial strain, compliance, and creep compared to TPE controls. The axial properties of the NiTi reinforced Bionate® BioFI™ implant best approximated those of a spinal disk followed by Kraton®-NiTi, Bionate® and Kraton® prototypes. An ovine lumbar segment biomechanical model was used to characterize the disk prosthesis prototypes. Specimens were subject to 7.5Nm pure moments in axial rotation, flexion-extension and lateral bending with a custom jig mounted on an Instron® 8874. The motion preserving ligamentous nature of this arthroplasty prototype was not inhibited by NiTi reinforcement. Joint stiffness for all prototypes was significantly less than the intact and discectomy controls. This was due to lack of vertebral anchor rigidity rather than BioFI™ motion segment matrix type or reinforcement. Implant stress profiles for axial compression and axial torsion conditions were obtained using finite element methods. The biomechanical testing and finite element modelling both support existing BioFI™ design specifications for higher modulus vertebral anchors, endplates and motion segment periphery with gradation to a low modulus core within the motion segment. This closer approximation of the native spinal disk form translates to improvements in prosthesis biomechanical fidelity and longevity. Axial compressive strain induced within a TiNi reinforced Kraton® BioFI™ was found to be linearly proportional to the NiTi helical coil electrical resistance. This neural network capability delivers opportunities to monitor and telemeterize in situ multiaxis joint structural performance and in vivo spine biomechanics.

scholarly journals In vivo intervertebral disc deformation: intratissue strain patterns within adjacent discs during flexion–extension

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Robert L. Wilson ◽  
Leah Bowen ◽  
Woong Kim ◽  
Luyao Cai ◽  
Stephanie Ellyse Schneider ◽  
...  
Keyword(s):  
Intervertebral Disc ◽  
Biomechanical Analysis ◽  
Resonance Imaging ◽  
Tissue Architecture ◽  
Mechanical Responses ◽  
Flexion Extension ◽  
Adjacent Disc ◽  
Shear Strains ◽  
Magnetic Resonance Imaging Mri

AbstractThe biomechanical function of the intervertebral disc (IVD) is a critical indicator of tissue health and pathology. The mechanical responses (displacements, strain) of the IVD to physiologic movement can be spatially complex and depend on tissue architecture, consisting of distinct compositional regions and integrity; however, IVD biomechanics are predominately uncharacterized in vivo. Here, we measured voxel-level displacement and strain patterns in adjacent IVDs in vivo by coupling magnetic resonance imaging (MRI) with cyclic motion of the cervical spine. Across adjacent disc segments, cervical flexion–extension of 10° resulted in first principal and maximum shear strains approaching 10%. Intratissue spatial analysis of the cervical IVDs, not possible with conventional techniques, revealed elevated maximum shear strains located in the posterior disc (nucleus pulposus) regions. IVD structure, based on relaxometric patterns of T2 and T1ρ images, did not correlate spatially with functional metrics of strain. Our approach enables a comprehensive IVD biomechanical analysis of voxel-level, intratissue strain patterns in adjacent discs in vivo, which are largely independent of MRI relaxometry. The spatial mapping of IVD biomechanics in vivo provides a functional assessment of adjacent IVDs in subjects, and provides foundational biomarkers for elastography, differentiation of disease state, and evaluation of treatment efficacy.

scholarly journals Buying Time: Long-Term Results of Wrist Denervation and Time to Repeat Surgery

Hand ◽  
2018 ◽  
Vol 14 (5) ◽  
pp. 602-608 ◽  
Author(s):  
Maureen A. O’Shaughnessy ◽  
Eric R. Wagner ◽  
Richard A. Berger ◽  
Sanjeev Kakar
Keyword(s):  
Symptom Relief ◽  
Long Term Results ◽  
Time Interval ◽  
Posttraumatic Arthritis ◽  
Revision Operation ◽  
Repeat Surgery ◽  
Age At Surgery ◽  
Flexion Extension ◽  
Wrist Denervation

Background: This study reviews long-term outcomes of partial wrist denervation focusing on need for and time to revision procedure. Methods: A retrospective study was conducted of all patients undergoing partial wrist denervation between 1994 and 2014. At average latest follow-up of 6.75 years (range, 1-21 years), clinical and radiographic data and need for revision surgery were recorded. Results: There were 100 wrists in 89 patients (61 male, 28 female) with average age at surgery of 54 years (range, 26-80). Principal diagnoses were arthritis (58%), inflammatory (19%), and posttraumatic arthritis (7%). Average flexion-extension arc was 83% and grip strength 75% of unaffected extremity. Average Mayo Wrist Scores improved from 48 preoperatively to 77 postoperatively. Sixty-nine percent of patients did not undergo other procedures during the time interval studied. Thirty-one percent underwent revision at an average of 26 months following denervation (range, 2-165). Conclusions: Partial wrist denervation is a motion-preserving procedure for patients with refractory wrist pain with 69% in this series requiring no further procedures. The remaining 31% experienced average symptom relief for 2 years prior to ultimately undergoing revision operation.

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