Journal of Orthopaedic Research®最新文献

{"title":"In Pursuit of Quantifying Patient Knee Contact Mechanics: Finite Element Model Validation of Cadaveric Knees in Axially Loaded MRI Scans","authors":"Brett D. Steineman,&nbsp;Kalle L. Chastain,&nbsp;Sean C. Letendre,&nbsp;Joshua Leadem,&nbsp;Kathryn Colone,&nbsp;Manuela Montes de Oca,&nbsp;Lila Pender,&nbsp;Madison Lang,&nbsp;Erin R. Leatherman,&nbsp;Erin Argentieri,&nbsp;Amanda Wach,&nbsp;Matthew F. Koff,&nbsp;Scott A. Rodeo,&nbsp;Amy L. Lerner,&nbsp;Suzanne A. Maher","doi":"10.1002/jor.26077","DOIUrl":"10.1002/jor.26077","url":null,"abstract":"<div>\u0000 \u0000 <p>Our long-term objective is to quantify patient-specific changes in contact mechanics after partial meniscectomy (PM) using knee-specific finite element (FE) models created from clinical MR scans under axial load. Before creating patient-specific models, a validation of our workflow and processes is required. The objective of this study was to validate knee-specific FE models of tibiofemoral joint contact mechanics by comparison to direct measurements of contact by electronic pressure sensors. We hypothesized that knee-specific FE model data would fall within direct measurements of the contact area and pressure values from sensors, but that detected differences in outcomes would be smaller than differences reported after PM. The workflow consisted of performing MRIs on five cadaveric knees using a patient-based loading system adapted to cadaveric knees where loaded and unloaded scans were acquired with and without a sensor in place, segmenting images to develop FE models, running those models with statistical approaches to model material property variation and comparing the model outputs to the outputs quantified physically by sensors. Overall, 53% of outcomes (32/60) from the FE models fell within the ranges of those directly measured. Of the values that fell outside, differences were lower than those identified from a literature review of the mechanical effects of partial meniscectomies, especially when meniscectomies were 30% or 60% of the meniscus volume. FE models developed using this workflow may be helpful in assessing or anticipating changes in joint force redistribution following partial meniscectomies in patients.</p>\u0000 </div>","PeriodicalId":16650,"journal":{"name":"Journal of Orthopaedic Research®","volume":"43 6","pages":"1132-1143"},"PeriodicalIF":2.1,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Membrane Filtration of Sonication Fluid—A Promising Adjunctive Method for the Diagnosis of Low-Grade Infection in Presumed Aseptic Nonunion","authors":"Katharina Trenkwalder,&nbsp;Sandra Erichsen,&nbsp;Ferdinand Weisemann,&nbsp;Peter Augat,&nbsp;SAND Research Group,&nbsp;Simon Hackl","doi":"10.1002/jor.26076","DOIUrl":"https://doi.org/10.1002/jor.26076","url":null,"abstract":"<p>Treatment guidelines for fracture nonunion differ based on the presence or absence of infection. Low-grade infections without preoperative clinical signs of infection are difficult to distinguish from aseptic cases. Membrane filtration of sonication fluid (MF) has been shown to be a useful method for identifying septic nonunion. Therefore, the aim of this study was to evaluate the diagnostic value of MF in differentiating low-grade infected nonunion from aseptic cases. A prospective multicenter clinical study enrolled 75 patients with femoral or tibial shaft nonunion with planned revision surgery and without clinical suspicion of infection. During revision surgery, tissue from the nonunion zone was sampled for culture and histopathology, and the implant for sonication with MF and colony forming unit (CFU) quantification. Infection was diagnosed according to the diagnostic criteria for fracture-related infection. The diagnostic performance of MF CFU count was evaluated by receiver operating characteristic (ROC) curve and compared with that of tissue culture (TC), sonication fluid broth culture (SFC), and Histopathological Osteomyelitis Evaluation Score (HOES). Fifty-three nonunion cases were aseptic, and 22 had a low-grade infection. ROC curve had an area under the curve of 0.84. The optimal CFU cutoff to discriminate between low-grade infected and aseptic nonunion was 11.1 CFU/10 mL sonication fluid with 64% sensitivity and 89% specificity. SFC showed a higher sensitivity of 82% but a lower specificity of 81%. The sensitivity and specificity of TC were 77% and 96%, respectively, and those of HOES were 9% and 87%, respectively. Implementation of MF in clinical diagnostics as an adjunct to TC may improve the differential diagnosis between low-grade infected nonunion and aseptic nonunion.</p>","PeriodicalId":16650,"journal":{"name":"Journal of Orthopaedic Research®","volume":"43 6","pages":"1203-1211"},"PeriodicalIF":2.1,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jor.26076","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143939300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In Vitro Characterization and In Vivo Performance of Vancomycin-Loaded PLGA Microspheres Prepared by Using Microfluidics for the Management of Orthopedic Infections","authors":"Dinesh Dhamecha,&nbsp;Mehmet D. Asik,&nbsp;Cecilia Nepple,&nbsp;Yingfang Fan,&nbsp;Amita Sekar,&nbsp;Keita Fujino,&nbsp;Fawaz Malick,&nbsp;Madeline McCanne,&nbsp;Ebru Oral,&nbsp;Orhun Muratoglu","doi":"10.1002/jor.26070","DOIUrl":"10.1002/jor.26070","url":null,"abstract":"<div>\u0000 \u0000 <p>Periprosthetic joint infection (PJI) is a severe complication of total joint arthroplasty (TJA), leading to high rates of revision surgeries, long-term morbidity, and mortality. Conventional antibiotic treatments often suffer from limited bioavailability and systemic toxicity. This study explores a novel approach using vancomycin-loaded poly(lactic-<i>co</i>-glycolic) acid (PLGA) microparticles (VMP) formulated via a microfluidic double emulsion method for controlled, localized drug delivery for managing PJI. The PLGA microparticles were synthesized to achieve high loading capacity and sustained vancomycin release, aiming to maintain therapeutic intra-articular concentrations. In vitro characterization demonstrated optimal loading capacity (up to 28% w/w), morphology with a homogeneous particle size distribution (49–65 µm), and sustained release profiles over 8 weeks. In vivo efficacy was evaluated using a rat joint infection model, showing significant reductions in bacterial viability and enhanced bone healing compared to controls. Weight-bearing recovery assessments showed that VMP-treated rats regained functionality significantly earlier than controls (<i>p</i> &lt; 0.05). Radiographic, histological, and immunofluorescent analyses confirmed reduced inflammation and improved bone integrity with VMP treatment. These findings suggest that microfluidic-synthesized PLGA microparticles provide a promising strategy for localized, controlled release of antibiotics, potentially helping the management of PJI and improving postsurgical outcomes. Future research should explore the long-term effects and scalability of clinical applications. This study lays the foundation for advancing controlled release systems in orthopedic postoperative care.</p>\u0000 </div>","PeriodicalId":16650,"journal":{"name":"Journal of Orthopaedic Research®","volume":"43 6","pages":"1191-1202"},"PeriodicalIF":2.1,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143676630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Automated Detection of Microcracks Within Second Harmonic Generation Images of Cartilage Using Deep Learning","authors":"Kosar Safari,&nbsp;Borja Rodriguez Vila,&nbsp;David M. Pierce","doi":"10.1002/jor.26071","DOIUrl":"10.1002/jor.26071","url":null,"abstract":"<div>\u0000 \u0000 <p>Articular cartilage, essential for smooth joint movement, can sustain micrometer-scale microcracks in its collagen network from low-energy impacts previously considered non-injurious. These microcracks may propagate under cyclic loading, impairing cartilage function and potentially initiating osteoarthritis (OA). Detecting and analyzing microcracks is crucial for understanding early cartilage damage but traditionally relies on manual analyses of second harmonic generation (SHG) images, which are labor-intensive, limit scalability, and delay insights. To address these challenges, we established and validated a YOLOv8-based deep learning model to automate the detection, segmentation, and quantification of cartilage microcracks from SHG images. Data augmentation during training improved model robustness, while evaluation metrics, including precision, recall, and F1-score, confirmed high accuracy and reliability, achieving a true positive rate of 95%. Our model consistently outperformed human annotators, demonstrating superior accuracy, repeatability, all while reducing labor demands. Error analyses indicated precise predictions for microcrack length and width, with moderate variability in estimations of orientation. Our results demonstrate the transformative potential of deep learning in cartilage research, enabling large-scale studies, accelerating analyses, and providing insights into soft tissue damage and engineered material mechanics. Expanding our data set to include diverse anatomical regions and disease stages will further enhance performance and generalization of our YOLOv8-based model. By automating microcrack detection, this study advances understanding of microdamage in cartilage and potential mechanisms of progression of OA. Our publicly available model and data set empower researchers to develop personalized therapies and preventive strategies, ultimately advancing joint health and preserving quality of life.</p></div>","PeriodicalId":16650,"journal":{"name":"Journal of Orthopaedic Research®","volume":"43 6","pages":"1101-1112"},"PeriodicalIF":2.1,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143670269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A High-Riding Patella Is a Feature of Knee Joint Motion During Gait After ACL Reconstruction","authors":"Marcus G. Pandy,&nbsp;Hans A. Gray,&nbsp;Padma N. Ganapam,&nbsp;Adam G. Culvenor,&nbsp;Kay M. Crossley,&nbsp;Shanyuanye Guan","doi":"10.1002/jor.26062","DOIUrl":"10.1002/jor.26062","url":null,"abstract":"<p>Accurate measurements of knee joint motion during gait after anterior cruciate ligament reconstruction (ACLR), especially for the patellofemoral joint, are sparse. The aim of this study was to measure six-degree-of-freedom (6-DOF) patellofemoral and tibiofemoral motion in ACLR and uninjured contralateral knees during gait, and to compare these results to healthy (control) knees. Biplane fluoroscopy was used to measure 6-DOF patellofemoral and tibiofemoral motion in 15 ACLR participants (26.3 ± 3.9 years) for complete cycles of level walking and downhill walking, and the results were compared to data for 10 healthy individuals (29.8 ± 6.1 years). Mean patellar superior translation, anterior translation, and flexion over the gait cycle were respectively 4.4–5.6 mm greater, 5.4–6.3 mm greater, and 3.7°–7.0° less in the ACLR and contralateral knees compared to controls across both activities (<i>p</i> &lt; 0.021). Articular contact was 7.6 mm higher on the femoral trochlea in the ACLR and contralateral knees compared to controls. The patellar tendon was 8.9 mm longer (<i>p</i> &lt; 0.001) in the ACLR and contralateral knees compared to controls. Among ACLR participants, 14 out of 30 knees (47%) had an Insall–Salvati ratio ≥ 1.20, indicating patella alta. Mean tibial external rotation and anterior translation over the gait cycle were respectively 3.4°–3.8° greater and 2.6–3.0 mm greater in the ACLR knee compared to controls across both activities (<i>p</i> &lt; 0.025). A high-riding patella in both knees of the ACLR participants was due to a longer patellar tendon. A change in the load-bearing areas of the femoral trochlea may contribute to the high rate of patellofemoral osteoarthritis seen after ACLR.</p>","PeriodicalId":16650,"journal":{"name":"Journal of Orthopaedic Research®","volume":"43 5","pages":"1024-1034"},"PeriodicalIF":2.1,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jor.26062","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Classification of Kinematic Coupling Patterns Between Lower Limb Joints During Running","authors":"Shiori Hiratsuka,&nbsp;Tomoya Takabayashi,&nbsp;Takahiro Watanabe,&nbsp;Takanori Kikumoto,&nbsp;Masayoshi Kubo","doi":"10.1002/jor.26074","DOIUrl":"10.1002/jor.26074","url":null,"abstract":"<div>\u0000 \u0000 <p>Abnormal foot alignment such flatfoot is involved in running injuries. The mechanism by which flatfoot is susceptible to running injuries has not yet been established. The purpose of this study was to classify kinematic coupling patterns by hierarchical clustering, adding individuals with flatfoot and motion in the transverse plane involved in running injuries, and to identify the factors that determine the clusters classified. Twenty-four young healthy adults were divided and classified into normal and flat foot groups of 12 participants each, using the foot posture index. The task involved treadmill running. Cross-correlation coefficients between the ankle and knee joints and between the knee and hip joint were used to evaluate kinematic coupling in the sagittal, frontal, and transverse planes during the stance phase. Hierarchical clustering was used to classify kinematic coupling patterns using the cross-correlation coefficient as an input variable. After cluster classification, joint angles during the stance phase and static standing were compared between clusters. Hierarchical clustering classified kinematic coupling patterns between lower limb joints into two clusters, mainly the kinematic coupling on the frontal plane. However, clusters were not classified by foot alignment. Significant differences in knee varus/valgus, hip adduction/abduction, and internal/external rotation angles during the stance phase were observed between clusters. Foot alignment was not involved in the cluster analysis in this study. Further detailed evaluation of foot alignment is required.</p>\u0000 </div>","PeriodicalId":16650,"journal":{"name":"Journal of Orthopaedic Research®","volume":"43 6","pages":"1171-1178"},"PeriodicalIF":2.1,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of Rotational Guided Growth With Flexible Tethers on the Distal Femoral Bone: An Experimental Study in a Porcine Model","authors":"Ahmed Halloum,&nbsp;Maria Tirta,&nbsp;Søren Kold,&nbsp;Shima Gholinezhad,&nbsp;Jan Duedal Rölfing,&nbsp;John Rasmussen,&nbsp;Ahmed A. Abood,&nbsp;Ole Rahbek","doi":"10.1002/jor.26073","DOIUrl":"10.1002/jor.26073","url":null,"abstract":"<p>New and innovative surgical techniques, using a flexible tether to correct rotational deformities of the growing femur have recently emerged, but are lacking radiographic validation of desired rotation and adverse effects in the frontal and sagittal planes. We, therefore, investigated this new technique in an established large animal model. Eight skeletally immature pigs were included in the study in a paired (left vs. right leg) design. Mean (range) observation time was 83 days (77–90). CT-scans and X-rays were performed immediately after insertion of the tethers and again at euthanasia after 12 weeks. From the CT-scans, 3D-models of the left and right femora were generated and analyzed for intended external rotation and unintended effects in other planes and bone morphology. One pig was excluded due to surgical site infection. Average change in rotation between the operated and non-operated femora was 7.2° (CI: 5.9–8.6) external rotation. We also found unintended valgus deformity in the coronal plane (7.8° (CI: 3.9–12.0) and unintended extension in the sagittal plane (3.9° (CI: −1.8 to 8.7). Unintended changes to the joint morphology were also observed. Rotation by guided growth was achieved with this surgical technique, confirmed by radiological measurements.</p><p><b>Clinical Significance.</b> While this large animal study has shown that this new surgical technique reliably corrected rotational deformities by guided growth, it has also revealed adverse effects that need further investigation before clinical use.</p>","PeriodicalId":16650,"journal":{"name":"Journal of Orthopaedic Research®","volume":"43 6","pages":"1164-1170"},"PeriodicalIF":2.1,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jor.26073","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mitochondrial Dysfunction of the Subsynovial Connective Tissue in Patients With Carpal Tunnel Syndrome","authors":"Shuya Tanaka,&nbsp;Yutaka Mifune,&nbsp;Atsuyuki Inui,&nbsp;Kohei Yamaura,&nbsp;Takahiro Furukawa,&nbsp;Tatsuo Kato,&nbsp;Masaya Kusunose,&nbsp;Tomoyuki Matsumoto,&nbsp;Takehiko Matsushita,&nbsp;Ryosuke Kuroda","doi":"10.1002/jor.26064","DOIUrl":"10.1002/jor.26064","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 <p>In idiopathic carpal tunnel syndrome (CTS), fibrosis and thickening of the subsynovial connective tissue (SSCT) increase pressure within the carpal tunnel, resulting in median nerve entrapment. Mitochondrial dysfunction in tissues reportedly leads to senescent cell accumulation and various diseases through reduced adenosine triphosphate (ATP) and excessive reactive oxygen species (ROS) production; however, no reports have linked this to CTS. Therefore, this study aimed to evaluate mitochondrial function in SSCTs of patients with CTS. This study investigated SSCTs obtained during carpal tunnel release surgery in patients with CTS (CTS group) and those obtained during tendon transfer or tendon rupture surgery in patients without CTS (control group) from April 2021 to March 2023 at our hospital. Outcome measures included superoxide dismutase (SOD) activity, gene expression levels, immunofluorescence staining, ATP production assays, and transmission electron microscopy (TEM). <i>p</i> values were calculated using the Mann–Whitney <i>U</i> test. The CTS and control groups included 10 and 5 patients (mean age, 67.8 ± 9.57 and 65.4 ± 9.75 years), respectively. The CTS group exhibited decreased SOD activity (<i>p</i> = 0.026), increased gene expression of mitochondrial biosynthetic factors, and decreased mitochondrial ATP production (<i>p</i> = 0.027). The CTS group showed increased mitochondrial ROS production (<i>p</i> = 0.038) on immunofluorescence and larger mitochondrial area (<i>p</i> = 0.030) and fewer mitochondrial cristae (<i>p</i> = 0.045) on TEM. Multiple mitochondrial function assays suggested mitochondrial dysfunction of SSCTs in the CTS group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Statement of Clinical Significance</h3>\u0000 \u0000 <p>This research provided important information on the histological changes in the subsynovial connective tissue within the carpal tunnel in carpal tunnel syndrome.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16650,"journal":{"name":"Journal of Orthopaedic Research®","volume":"43 5","pages":"1045-1053"},"PeriodicalIF":2.1,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The LINC Complex Regulates Tendon Elastic Modulus, Collagen Crimp, and Lateral Expansion During Early Postnatal Development","authors":"Nicholas M. Pancheri,&nbsp;Jordan T. Daw,&nbsp;Destinee Ditton,&nbsp;Nathan R. Schiele,&nbsp;Scott Birks,&nbsp;Gunes Uzer,&nbsp;Calvin L. Jones,&nbsp;Brian T. Penney,&nbsp;Sophia K. Theodossiou","doi":"10.1002/jor.26069","DOIUrl":"10.1002/jor.26069","url":null,"abstract":"<div>\u0000 \u0000 <p>There is limited understanding of how mechanical signals regulate tendon development. The nucleus has emerged as a major regulator of cellular mechanosensation via the linker of nucleoskeleton and cytoskeleton (LINC) protein complex. Specific roles of LINC in tenogenesis have not been explored. In this study, we investigate how LINC regulates tendon development by disabling LINC-mediated mechanosensing via dominant negative (dn) overexpression of the Klarsicht, ANC-1, and Syne Homology (KASH) domain, which is necessary for LINC to function. We hypothesized that LINC regulates mechanotransduction in developing tendons and that disabling LINC would impact tendon's mechanical properties and structure in a mouse model of dnKASH. We used Achilles tendon (AT) and tail tendon (TT) as representative energy-storing and positional tendons, respectively. Mechanical testing at postnatal day 10 showed that disabling the LINC complex via dnKASH significantly impacted tendon mechanical properties and cross-sectional area and that the effects differed between ATs and TTs. Collagen crimp distance was also impacted in dnKASH tendons and was significantly decreased in ATs and increased in TTs. Overall, we show that disruption to the LINC complex specifically impacts tendon mechanics and collagen crimp structure, with unique responses between an energy-storing and limb-positioning tendon. This suggests that nuclear mechanotransduction through LINC plays a role in regulating tendon formation during neonatal development.</p>\u0000 </div>","PeriodicalId":16650,"journal":{"name":"Journal of Orthopaedic Research®","volume":"43 6","pages":"1090-1100"},"PeriodicalIF":2.1,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Grip Force Modulation on Median Nerve Morphology Changes","authors":"Shengwei Li,&nbsp;Aaron M. Kociolek,&nbsp;Lizbeth A. Mariano,&nbsp;Ping Yeap Loh","doi":"10.1002/jor.26068","DOIUrl":"10.1002/jor.26068","url":null,"abstract":"<p>Compression on the median nerve can lead to carpal tunnel syndrome (CTS), and median nerve indicators measured from ultrasound images can be used for CTS diagnosis. The aim of this study was to investigate the relationship between grip force modulation and dynamic morphological changes of the median nerve. We used a digital grip dynamometer to measure grip force while simultaneously conducting ultrasound examinations. Ultrasound images were sampled for both the dominant and nondominant hands of all participants (<i>n</i> = 20) during a baseline condition at approximately 0% maximum voluntary force (MVF), during sustained grip force conditions at 25%, 50%, 75%, and 100% MVF, and during the return to a relaxed state (≈0% MVF) directly following each grip force condition. Regardless of hand dominance, grip force level, and grip force modulation, median nerve cross-sectional area (MNCSA) during the grip tasks was smaller relative to the initial baseline condition without grip force. With respect to shape change, the median nerve became more flattened, including increased longitudinal diameter (D1) and decreased vertical diameter (D2), when grip force was relaxed compared to the preceding sustained grip force condition for the dominant hand; however, there were no significant shape changes for the nondominant hand. As morphological changes to tissue result in strain, our results indicate that median nerve injury development may be associated with more hand usage (dominant hand, grip exertion, and grip force modulation), and further suggests the evaluative potential for median nerve dynamics within the carpal tunnel.</p>","PeriodicalId":16650,"journal":{"name":"Journal of Orthopaedic Research®","volume":"43 6","pages":"1179-1190"},"PeriodicalIF":2.1,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jor.26068","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}