By introducing a novel method for studying dynamic wrist motions we expect to set up a new non-invasive method which is expected to result in early diagnosis of abnormal carpal movements after ligament disruption. By comparing healthy individuals…
ID
Source
Brief title
Condition
- Tendon, ligament and cartilage disorders
Synonym
Research involving
Sponsors and support
Intervention
Outcome measures
Primary outcome
Intervention:
In all groups both wrists will be scanned by our 4D-CT method during
flexion/extension and radioulnair deviation. Same scans are obtained once again
while axial loading is extended during flexion/extension and radioulnar
deviation. 3 months after a reconstructive procedure the operated wrist is
scanned again to evaluate and study the effects of such operations. A novel
method for 3D dynamic imaging of the wrist is introduced, which uses Computed
tomographic (CT) imaging. The open geometry of the CT provides a compliant
workspace for several postures.
Main study parameters/ endpoints:
We expect to find changed motion patterns in wrist after a scapholunate
ligament injury and even after reconstruction of this ligament. From this study
acquired information would enable us to lay down the principles of a
non-invasive tool for detection of carpal instabilities that occur after
ligament injury.
Secondary outcome
not applicable
Background summary
Due to complex architecture of the wrist, the wrist joint is associated with
several problems of overuse, damage and instability. Scapholunate dissociation
(SLD) caused by disruption of the scapholunate ligament is arguably the most
common form of carpal instability. Due to delayed diagnosis sooner or later
carpal instability results in irreversible degenerative changes of the wrist.
SLD may not show definite abnormalities in static radiologic study, but may
show abnormalities during wrist movement. There are several ways to diagnose
SLD, such as: plain radiography, videofluoroscopy, ultrasound, arthroscopy and
MRI scans. All of these have disadvantages like static imaging, being invasive,
time consuming, over projection of carpal bones and poor resolution which will
result in problems during diagnosing,. So a non-invasive method which could
provide us dynamic 3D information would give us the opportunity to detect
dynamic wrist pathologies after ligament injury. For this reason we recently
introduced a new method for the acquisition of dynamic 3D images of a moving
joint. 4D-CT gives us the ability to study individual wrist bone movements
patterns which is expected result in earlier diagnosis of SLD.
Study objective
By introducing a novel method for studying dynamic wrist motions we expect to
set up a new non-invasive method which is expected to result in early diagnosis
of abnormal carpal movements after ligament disruption. By comparing healthy
individuals with those with scapholunate ligament dissociation we will detect
abnormal motion patterns which we will quantify by 3 translations and 3
rotations (6 degrees of freedom) of each individual wrist bone. Such
delineation of specific motion patterns will enable us to set up new
definitions for different wrist pathologies, such as ligamentous injuries, that
are based on the dynamic properties of the wrist joint. By rescanning patients
with scapholunate ligament ruptures after a reconstructive procedure we will
investigate benefits of such interventions. Information from this pilot study
will be used for an upcoming accuracy study where the diagnostic value of our
method will be determined.
Study design
Diagnostic case-control pilot.
Study burden and risks
For healthy individuals this means a net radiation exposure of 0.3 mSv. For
people with scapholunate
ligament dissociation this exposure will be 0.6 mSv.
Suite G4-226, AMC, Meibergdreef 9
Amsterdam 1100 DD
NL
Suite G4-226, AMC, Meibergdreef 9
Amsterdam 1100 DD
NL
Listed location countries
Age
Inclusion criteria
Fist part of the study will assess only healthy volunteers.
For the second part of the study: People with a proven scapholunate ligament lesion;For the third part of the experiment patient from the second group are scanned after a reconstructive surgery.
Exclusion criteria
For the first part of the study:
-Injury or disorders of the wrist in history
-Familiar with skeletal and/ or connective-tissue diseases
-Not able to understand the written informed consent.
-Pregnancy
For the second and third part of the study
-Not able to understand the written informed consent.
-Pregnancy
Design
Recruitment
Followed up by the following (possibly more current) registration
No registrations found.
Other (possibly less up-to-date) registrations in this register
No registrations found.
In other registers
| Register | ID |
|---|---|
| CCMO | NL44780.018.13 |