Walker Lizzie, Gordon Daniel, Chiaramonti Alexander, Wang Shangping, Meng Zhaoxu, Daley Dane, Slate Elizabeth, Yao Hai, Pellegrini Vincent D, Wu Yongren
Department of Bioengineering, Clemson University, 68 President Street, BEB 203, Charleston, SC, 29425, USA.
Department of Orthopaedic Surgery and Rehabilitation, Wake Forest University School of Medicine, Winston Salem, NC, USA.
Ann Biomed Eng. 2025 Apr;53(4):799-811. doi: 10.1007/s10439-024-03660-4. Epub 2024 Dec 7.
To identify changes in morphological and mechanical properties in the volar ligament complex (VLC), dorsoradial ligaments (DRL), and posterior oblique ligaments (POL) in healthy and osteoarthritic female trapeziometacarpal (TMC) joints.
Twenty-four fresh-frozen female cadaveric TMCs were separated into (1) younger healthy/early-stage osteoarthritic, (2) elder healthy/early-stage osteoarthritic, and (3) advanced-stage osteoarthritic groups based on age and Eaton-Littler grading. Stress relaxation and load-to-failure testing were performed to characterize mechanical tensile properties. Light imaging and scanning electron microscopy (SEM)/energy dispersive spectroscopy (EDS) were performed to further assess enthesis structural integrity.
The VLC in advanced-stage osteoarthritic TMCs had attenuated mechanical properties in stress relaxation experiments compared to the elder healthy/early-stage osteoarthritic specimens: Young's modulus at 20% strain (P = 0.044), instantaneous (P = 0.023), relaxed (P = 0.017) moduli. VLCs in advanced-stage osteoarthritic TMCs also had significantly lower properties in the load-to-failure experiments compared to the younger healthy/early-stage osteoarthritic specimens: stiffness (P = 0.048), ultimate load (P = 0.017), toughness (P = 0.003). Light and SEM/EDS imaging revealed partial detachment and loss of enthesis mineral gradient at VLC metacarpal insertion in advanced-stage osteoarthritic specimens. There were no mechanical or structural changes in the DRL and POL between experiment groups.
VLC morphological and mechanical properties deteriorate across progressively severe osteoarthritis classifications while the DRL and POL remain unchanged. The attenuated mechanical properties of VLCs in advanced-stage osteoarthritic TMCs can be explained by ligament degradation as evidenced by partial detachment and loss of mineral gradient at the metacarpal insertion.
确定健康和患骨关节炎的女性大多角骨-第一掌骨（TMC）关节掌侧韧带复合体（VLC）、背桡侧韧带（DRL）和后斜韧带（POL）的形态学和力学性能变化。
根据年龄和伊顿-利特勒分级，将24个新鲜冷冻的女性尸体TMC分为（1）年轻健康/早期骨关节炎组、（2）年长健康/早期骨关节炎组和（3）晚期骨关节炎组。进行应力松弛和破坏载荷测试以表征机械拉伸性能。进行光学成像和扫描电子显微镜（SEM）/能量色散光谱（EDS）以进一步评估韧带附着点的结构完整性。
与年长健康/早期骨关节炎标本相比，晚期骨关节炎TMC中的VLC在应力松弛实验中的力学性能减弱：20%应变时的杨氏模量（P = 0.044）、瞬时模量（P = 0.023）、松弛模量（P = 0.017）。与年轻健康/早期骨关节炎标本相比，晚期骨关节炎TMC中的VLC在破坏载荷实验中的性能也显著更低：刚度（P = 0.048）、极限载荷（P = 0.017）、韧性（P = 0.003）。光学和SEM/EDS成像显示晚期骨关节炎标本中VLC掌骨附着处有部分脱离和韧带附着点矿物质梯度丧失。实验组之间DRL和POL没有力学或结构变化。
随着骨关节炎严重程度的逐渐增加，VLC的形态学和力学性能恶化，而DRL和POL保持不变。晚期骨关节炎TMC中VLC力学性能的减弱可通过韧带退变来解释，掌骨附着处的部分脱离和矿物质梯度丧失证明了这一点。
