Effects of Surgical Repair or Reconstruction on Radiocarpal Mechanics from Wrists with Scapholunate Ligament Injury by Joshua E Johnson MSc (ME), University of Kansas, Lawrence, Kansas, USA BEng (ME), University of Botswana, Gaborone, Botswana Submitted to the graduate degree program in Mechanical Engineering and the Graduate Faculty of the University of Kansas School of Engineering in partial fulfillment of the requirements for the degree of Doctor of Philosophy Committee: ___________________________________ Chairperson: Kenneth J Fischer, PhD ___________________________________ Phil Lee, PhD ___________________________________ Terence E McIff, PhD ___________________________________ Carl W Luchies, PhD ___________________________________ Michael Detamore, PhD Date defended: ___________________ The Dissertation Committee for Joshua E Johnson certifies that this is the approved version of the following dissertation: Effects of Surgical Repair or Reconstruction on Radiocarpal Mechanics from Wrists with Scapholunate Ligament Injury Committee: ___________________________________ Chairperson: Kenneth J Fischer, PhD ___________________________________ Phil Lee, PhD ___________________________________ Terence E McIff, PhD ___________________________________ Carl W Luchies, PhD ___________________________________ Michael Detamore, PhD Date approved: ___________________ ii Table of Contents Acknowledgements ....................................................................................................................... vii Table of Figures ............................................................................................................................. ix List of Acronyms ......................................................................................................................... xiii Abstract ........................................................................................................................................... 1 Motivation ....................................................................................................................................... 3 Specific aim 1 ............................................................................................................................. 4 Research question ................................................................................................................... 4 Hypothesis ............................................................................................................................... 4 Specific aim 2 ............................................................................................................................. 4 Research question ................................................................................................................... 5 Hypothesis ............................................................................................................................... 5 Specific aim 3 ............................................................................................................................. 5 Research question ................................................................................................................... 6 Hypothesis ............................................................................................................................... 6 1. Background ............................................................................................................................. 9 1.1. Introduction ...................................................................................................................... 9 1.1.1. Basic anatomy and function ...................................................................................... 9 1.1.2. Anatomy and function of the scapholunate interosseous ligament ......................... 13 1.1.3. Kinematics and carpal stability ............................................................................... 17 1.1.4. Overview of carpal injuries ..................................................................................... 23 1.1.5. Classification of carpal instability .......................................................................... 24 1.2. Scapholunate ligament injury/scapholunate instability .................................................. 26 1.2.1. Pathophysiology and mechanism of injury ............................................................. 26 1.2.2. Diagnosis................................................................................................................. 27 1.2.3. Clinical classification .............................................................................................. 30 1.2.4. Treatment ................................................................................................................ 30 iii 1.3. Osteoarthritis and associated factors .............................................................................. 35 1.4. The role of magnetic resonance imaging ....................................................................... 39 1.5. Modeling approach ......................................................................................................... 43 1.6. References ...................................................................................................................... 49 2. Results of Automatic Image Registration are Dependent on Initial Manual Registration... 61 2.1. Abstract .......................................................................................................................... 64 2.2. Introduction .................................................................................................................... 65 2.3. Methods .......................................................................................................................... 65 2.4. Results ............................................................................................................................ 67 2.5. Discussion ...................................................................................................................... 68 2.6. References ...................................................................................................................... 70 2.7. Tables ............................................................................................................................. 72 2.8. Figures ............................................................................................................................ 74 3. Scapholunate Ligament Injury Adversely Alters In Vivo Wrist Joint Mechanics. An MRI-based Modeling Study .......................................................................................................... 77 3.1. Abstract .......................................................................................................................... 80 3.2. Introduction .................................................................................................................... 81 3.3. Methods .......................................................................................................................... 83 3.4. Results ............................................................................................................................ 86 3.5. Discussion ...................................................................................................................... 87 3.6. References ...................................................................................................................... 92 3.7. Tables ............................................................................................................................. 95 3.8. Figures ............................................................................................................................ 96 4. Effectiveness of Surgical Reconstruction to Restore Radiocarpal Joint Mechanics After Scapholunate Ligament Injury. An In Vivo Modeling Study ..................................................... 101 iv 4.1. Abstract ........................................................................................................................ 104 4.2. Introduction .................................................................................................................. 105 4.3. Materials and methods ................................................................................................. 106 4.4. Results .......................................................................................................................... 108 4.5. Discussion .................................................................................................................... 110 4.6. References .................................................................................................................... 115 4.7. Tables ........................................................................................................................... 118 4.8. Figures .......................................................................................................................... 119 5. Computationally Efficient MRI-based Surface Contact Modeling as a Tool to Evaluate Joint Injuries and Outcomes of Surgical Interventions........................................................................ 123 5.1. Abstract .......................................................................................................................