Kim Yoon Hyuk, Yao Zhidong, Kim Kyungsoo, Park Won Man
Department of Mechanical Engineering, Kyung Hee University, Yongin 446-701, South Korea.
Department of Mechanical Engineering, Kyung Hee University, Yongin 446-701, South Korea.
Man Ther. 2014 Jun;19(3):235-41. doi: 10.1016/j.math.2013.11.003. Epub 2013 Nov 20.
It may be assumed that the stability is affected when some ligaments are injured or loosened, and this joint instability causes sacroiliac joint pain. Several physical examinations have been used to diagnose sacroiliac pain and to isolate the source of the pain. However, more quantitative and objective information may be necessary to identify unstable or injured ligaments during these tests due to the lack of understanding of the quantitative relationship between the physical tests and the biomechanical parameters that may be related to pains in the sacroiliac joint and the surrounding ligaments. In this study, a three-dimensional finite element model of the sacroiliac joint was developed and the biomechanical conditions for six typical physical tests such as the compression test, distraction test, sacral apex pressure test, thigh thrust test, Patrick's test, and Gaenslen's test were modelled. The sacroiliac joint contact pressure and ligament strain were investigated for each test. The values of contact pressure and the combination of most highly strained ligaments differed markedly among the tests. Therefore, these findings in combination with the physical tests would be helpful to identify the pain source and to understand the pain mechanism. Moreover, the technology provided in this study might be a useful tool to evaluate the physical tests, to improve the present test protocols, or to develop a new physical test protocol.
可以假定，当一些韧带受伤或松弛时，稳定性会受到影响，而这种关节不稳定会导致骶髂关节疼痛。已经使用了几种体格检查来诊断骶髂关节疼痛并确定疼痛来源。然而，由于对体格检查与可能与骶髂关节及周围韧带疼痛相关的生物力学参数之间的定量关系缺乏了解，在这些检查过程中可能需要更多定量和客观的信息来识别不稳定或受伤的韧带。在本研究中，建立了骶髂关节的三维有限元模型，并对诸如压缩试验、牵引试验、骶骨尖压力试验、大腿推压试验、帕特里克试验和盖恩斯伦试验等六种典型体格检查的生物力学条件进行了建模。对每次试验的骶髂关节接触压力和韧带应变进行了研究。各试验的接触压力值以及应变最高的韧带组合有显著差异。因此，这些发现与体格检查相结合将有助于确定疼痛来源并理解疼痛机制。此外，本研究提供的技术可能是评估体格检查、改进现有试验方案或制定新的体格检查方案的有用工具。
