Assessing scaphotrapeziotrapezoid arthrokinematics using 4DCT

使用 4DCT 评估舟骨梯形关节运动学

• 批准号: 10604483
• 负责人: Taylor Patricia Trentadue
• 金额: $ 4.79万
• 依托单位: MAYO CLINIC ROCHESTER
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-07-01 至 2026-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10604483
• 关键词: 3-Dimensional; Adult; Affect; Age; Age Years; Anatomy; Articulation; Artificial Intelligence; Attention; Bilateral; Biological Markers; Biomechanics; Communication; Complex; Coupling; Data; Degenerative polyarthritis; Diagnosis; Diagnostic; Diagnostic Imaging; Distal; Elderly; Facet joint structure; Female; Foundations; Four-dimensional; Geometry; Hand; Hand Osteoarthritis; High Prevalence; Image; Imaging technology; Impairment; Incidence; Intervention; Joints; Lifting; Machine Learning; Measurement; Measures; Mechanics; Methods; Modeling; Morphology; Motion; Operative Surgical Procedures; Pain; Participant; Pathogenesis; Pathologic; Patients; Pattern; Positioning Attribute; Prevalence; Protocols documentation; Proxy; Quality of life; Radial; Resistance; Resolution; Role; Scaphoid bone; Series; Shapes; Side; Site; Stress; Structure; Structure-Activity Relationship; Surface; Techniques; Technology; Therapeutic; Thumb structure; Time; Translations; Trapezoid bone structure; Variant; Visualization; Work; Wrist; Wrist joint; X-Ray Computed Tomography; base; biomedical imaging; bone; carpus bone; clinical translation; combinatorial; diagnosis standard; diagnostic strategy; evidence base; four-dimensional computed tomography; hand dysfunction; improved; innovation; joint stress; lifetime risk; novel; photon-counting detector; pre-clinical; pressure; radiological imaging; sex; synergism; temporal measurement; tool; transmission process; trapezium; treatment strategy; two-dimensional; wrist motion

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.

项目概要/摘要 腕部骨关节炎 (OA) 是一种普遍存在的、使人衰弱的疾病。然而，有限的注意力集中在 舟骨梯形（STT）关节。 STT 位于手腕的桡侧，横跨两排 腕骨并桥接拇指和腕关节。 STT OA 影响 15% 至 24% 的成年人 45 岁，随着年龄的增长和女性性别的增加，患病率和发病率也会增加。然而， 与手关节相比，STT 受到的诊断和治疗关注有限。手腕是 解剖学上复杂：腕骨的数量、独特的几何形状、小尺寸和紧密接近 诊断成像和指导循证手术干预的挑战。由于腕骨错综复杂 相互关系，是运动和负载期间正常 STT 功能的强大生物力学基础 对于在不影响其余症状的情况下制定治疗有症状的 STT OA 的干预措施至关重要 腕骨或拇指。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。具体来说，需要动态测量骨运动 了解手腕和手的各种运动过程中腕骨之间的关系 不同的负载条件。 4DCT（随时间变化的 3DCT）生成在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，提供动态捕捉骨骼的令人兴奋的能力。 骨间邻近分布、压力代理和最近邻近中心将用于 将关节​​关系描述为运动和载荷的函数，从而深入了解 未受影响和病理状态下的 STT 关节。此外，关节空间的大小和可变性 每个 STT 关节的形状尚未严格量化。统计形状建模 (SSM) 和 对从未受影响和病理性 STT 关节收集的 STT 腕骨进行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正常和病理条件下的 STT 关节运动学 以下目标。目标 1：量化无阻力和阻力手腕和拇指运动期间的 STT 关节运动学， 分别在没有手腕 OA 的参与者中量化 STT 形态的正常变化。目标 2：量化 使用早期 STT OA 患者无抵抗活动与抵抗活动期间的 STT 关节运动学 对未受影响的 STT 关节和病理性 STT 关节进行 4DCT 并比较 3D 形态。 4DCT 数据阐明运动 以及对关节施加压力的载荷，而形态数据则表明结构变化的部位。并行分析 将使我们能够定义 STT 关节处的结构-功能相互作用。这些目标将达到顶峰 全面了解 STT 负荷如何影响患有和不患有 OA 的参与者的关节运动学。一个 对形态和载荷在挑衅动作中的作用的综合理解将增强我们的能力 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。