Ong Joachim Ee En, Teng Shi Lei, McGrouther Duncan Angus, Leo Hwa Liang, Wong Yoke Rung
Department of Mechanical Engineering, National University of Singapore, Singapore.
Biomechanics Laboratory, Singapore General Hospital, Singapore.
Comput Methods Biomech Biomed Engin. 2023 Sep;26(9):1077-1085. doi: 10.1080/10255842.2022.2106133. Epub 2022 Aug 1.
Understanding the stresses on the scapholunate interosseous ligament (SLIL) and its interaction with synovial fluid pressure could be vital to improve wrist treatment for various wrist conditions such as arthritis, sprains and tendonitis. This study investigated the interaction between the intra-articular pressure, specifically the synovial fluid pressure change and the SLIL stresses in a computational model during wrist radioulnar deviation (RUD). Magnetic resonance imaging (MRI) scans were used to acquire the anatomical model of the carpal bones and ligament, while the kinematics of scaphoid and lunate were obtained through dynamic computerized tomography (CT) scans. A two-way fluid-structure interaction (FSI) was used to model the dynamics between the scaphoid and lunate, the SLIL, and the synovial fluid. The synovial fluid pressure change was found to be small (-4.86 to 3.23 Pa) and close to that simulated in a previous work without the SLIL (-1.68 to 2.64 Pa). Furthermore, peaks of maximum fluid pressure were found to trail the peaks of ligament stress. Therefore, it is suggested that the influence of synovial fluid pressure on the ligament in the SLIL model is negligible and simulations of the scapholunate joint could forego fluid-structure interactions. Future studies can instead explore other structures in the carpus that can possibly contribute to the ligament stresses. Clinically, treatments can be targeted at these areas to help prevent or slow the progression of ligament injuries into serious consequences like the degenerative joint disease.
了解舟月骨间韧带（SLIL）所承受的应力及其与滑液压力的相互作用，对于改善各种腕部疾病（如关节炎、扭伤和肌腱炎）的腕部治疗可能至关重要。本研究在腕部桡尺偏斜（RUD）的计算模型中，研究了关节内压力，特别是滑液压力变化与SLIL应力之间的相互作用。使用磁共振成像（MRI）扫描获取腕骨和韧带的解剖模型，同时通过动态计算机断层扫描（CT）扫描获得舟骨和月骨的运动学数据。采用双向流固耦合（FSI）方法对舟骨和月骨、SLIL以及滑液之间的动力学进行建模。发现滑液压力变化很小（-4.86至3.23 Pa），与先前无SLIL的工作中模拟的结果相近（-1.68至2.64 Pa）。此外，最大流体压力峰值滞后于韧带应力峰值。因此，提示在SLIL模型中滑液压力对韧带的影响可忽略不计，舟月关节的模拟可忽略流固耦合作用。未来的研究可以探索腕骨中其他可能导致韧带应力的结构。在临床上，治疗可以针对这些部位，以帮助预防或减缓韧带损伤发展为退行性关节疾病等严重后果。
