Assessing scaphotrapeziotrapezoid arthrokinematics using 4DCT

项目摘要/摘要 手腕骨关节炎(OA)是一种普遍的、令人衰弱的疾病；然而，有限的注意力集中在 舟骨斜方形(STT)关节。STT位于手腕的放射侧，横跨两行 腕骨连接拇指和手腕关节。STT OA对15%至24%以上的成年人产生影响 45岁，随着年龄和女性的增加，患病率和发病率增加。然而， 与手关节相比，STT得到的诊断和治疗关注有限。手腕是 解剖学上的复杂性：腕骨的数量、独特的几何形状、小的尺寸和非常接近的姿势 诊断成像和指导循证外科干预的挑战。由于错综复杂的腕骨 相互关系是运动和负重状态下正常STT功能的强大生物力学基础 对于量身定做干预措施，在不影响其余STT OA的情况下纠正症状性STT OA至关重要 手腕或拇指。因此，有必要了解腕骨之间复杂的相互作用 未受影响的参与者的运动。具体地说，需要动态测量骨骼运动以 了解腕部和手部不同动作时腕骨之间的关系 不同的加载条件。4DCT(随时间变化的3DCT)生成在以下时间捕获的图像体积的时间序列 具有高空间和时间分辨率的运动，提供令人兴奋的动态捕捉骨骼的能力。 将使用骨间邻近分布、压力的替代指标和最近邻近中心来 将关节关系描述为运动和载荷的函数，从而深入了解 STT关节处于未受影响和病理状态。此外，节理空间和节理空间的大小和变化 每个STT关节处的形状还没有被严格量化。统计形状建模(SSM)和 对从未受影响和有病变的STT关节收集的STT腕骨的机器学习将使我们能够 阐明运动过程中关节表面相互作用的几何形状与骨骼之间的相互作用 形态学。我们的研究旨在了解STT在正常和病理条件下的关节运动学。 遵循目标。目标1：量化STT在手腕和拇指无阻力和阻力运动时的关节运动学， 另外，在没有腕关节骨关节炎的参与者中，量化STT形态的正常变异。目标2：量化 STT早期骨性关节炎患者在无阻力和阻力活动中的关节运动学研究 4DCT扫描，比较正常和病理性STT关节的三维形态。4DCT数据阐明运动 以及对关节施加应力的载荷，而形态数据表明结构变化的位置。平行分析 将使我们能够定义STT关节的结构-功能相互作用。这些目标将在一场 STT负荷如何影响患有和不患有骨性关节炎的参与者的关节运动学。一个 对形态和负荷在挑衅动作中的作用的综合理解将增强我们的 了解这一复杂的关节，促进生物力学驱动的诊断和治疗策略。

PROJECT SUMMARY / ABSTRACT Wrist osteoarthritis (OA) is a prevalent, debilitating condition; however, limited attention has focused on the scaphotrapeziotrapezoid (STT) joint. The STT is positioned on the radial side of the wrist, spanning both rows of carpal bones and bridging the thumb and wrist joints. STT OA impacts between 15% and 24% of adults over 45 years of age, with increased prevalence and incidence given advancing age and female sex. However, compared to hand joints, the STT has received limited diagnostic and therapeutic attention. The wrist is anatomically complex: the number, unique geometries, small size, and close proximities of carpal bones pose challenges for diagnostic imaging and guiding evidence-based surgical interventions. Due to intricate carpal interrelationships, a strong biomechanical foundation of normal STT function during motion and under loading is critical for tailoring interventions that remedy symptomatic STT OA without compromising the remainder of the carpus or thumb. Thus, there is a need to understand the complex interplay between carpal bones during motion in unaffected participants. Specifically, there is a need to measure bone motion dynamically to understand the relationships between carpal bones during various motions of the wrist and hand under different loading conditions. 4DCT (3DCT over time) yields a time series of image volumes captured during motion with high spatial and temporal resolution, offering the exciting capability to capture bones dynamically. Interosseous proximity distributions, a proxy for pressure, and centers of closest proximity will be used to describe the joint relationships as a function of motion and loading, conferring an in-depth understanding of the STT joint in both unaffected and pathological states. Further, the magnitude and variability of joint space and shape at each STT articulation have not been rigorously quantified. Statistical shape modeling (SSM) and machine learning of STT carpal bones collected from unaffected and pathological STT joints will allow us to elucidate the interactions between interacting geometries of articulating surfaces during motion and bone morphology. Our study aims to understand STT arthrokinematics in normal and pathological conditions in the following aims. Aim 1: Quantify STT arthrokinematics during unresisted and resisted wrist and thumb motions, separately, in participants without wrist OA and quantify normal variations in STT morphology. Aim 2: Quantify STT arthrokinematics during unresisted versus resisted activities in patients with early-stage STT OA using 4DCT and compare 3D morphologies of unaffected and pathologic STT joints. 4DCT data elucidate motions and loads that stress the joint, while morphologic data indicate sites of structural change. A parallel analysis will allow us to define structure-function interactions at the STT joint. The Aims will culminate in a comprehensive view of how STT loading impacts arthrokinematics in participants with and without OA. An integrative understanding of morphology and the role of load in provocative maneuvers will enhance our understanding of this complex joint, promoting biomechanically motivated diagnostic and treatment strategies.