Assessing scaphotrapeziotrapezoid arthrokinematics using 4DCT

项目概要/摘要 腕关节骨关节炎（OA）是一种普遍的、使人衰弱的疾病;然而，有限的注意力集中在 舟骨小多角（STT）关节。STT位于腕关节的桡侧，横跨两排 连接拇指和腕关节。STT OA影响15%至24%的成年人， 45岁，随着年龄和女性的增长，流行率和发病率增加。然而，在这方面， 与手关节相比，STT受到的诊断和治疗关注有限。手腕 解剖学上复杂：腕骨的数量、独特的几何形状、小尺寸和紧密的接近度构成了 诊断成像和指导循证外科干预的挑战。由于复杂的腕骨 相互关系，在运动和负荷下正常STT功能的强大生物力学基础 对于定制治疗症状性STT OA的干预措施而不影响剩余的 腕骨或拇指。因此，有必要了解腕骨之间的复杂的相互作用， 不受影响的参与者。具体地，需要动态地测量骨骼运动，以 了解手腕和手在各种运动过程中腕骨之间的关系 不同的加载条件。4DCT（随时间的3DCT）产生在以下期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获骨骼的能力。 骨间邻近分布，压力的代理，以及最近邻近的中心将被用于 将关节关系描述为运动和载荷的函数，从而深入了解 STT关节在未受影响和病理状态。此外，关节间隙的大小和可变性以及 每个STT关节的形状尚未严格量化。统计形状建模（SSM） 从未受影响和病理性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面的相互作用几何形状与骨之间的相互作用 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， 的目标。目的1：量化无阻力和有阻力的手腕和拇指运动期间的STT关节运动学， 分别在没有腕关节OA的参与者中，量化STT形态的正常变化。目标2：量化 早期STT OA患者在非抵抗性与抵抗性活动期间的STT关节运动学 4DCT和比较未受影响和病理STT关节的3D形态。4DCT数据阐明运动 和对关节施加应力的载荷，而形态数据表明结构变化的部位。平行分析 将允许我们定义STT关节处的结构-功能相互作用。目标将在一个 全面了解STT负荷如何影响OA和非OA参与者的关节运动学。一个 对形态学和载荷在挑衅性机动中的作用的综合理解，将提高我们的 了解这种复杂的关节，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.