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J Wrist Surg 2022; 11(05): 406-415
DOI: 10.1055/s-0041-1740486
Scientific Article

Normal Values of Distal Radioulnar Joint Kinematics during a Dynamic Press Test

Janni Kjærgaard Thillemann 
1   Department of Orthopaedics, University Clinic for Hand, Hip and Knee Surgery, Hospital Unit West, Holstebro, Denmark
2   Department of Clinical Medicine, Aarhus University, Aarhus N, Denmark
3   AutoRSA Research Group, Orthopaedic Research Unit, Aarhus University Hospital, Aarhus N, Denmark
,
Sepp De Raedt
3   AutoRSA Research Group, Orthopaedic Research Unit, Aarhus University Hospital, Aarhus N, Denmark
4   NRT X-RAY A/S, Hasselager, Denmark
,
Emil Toft Petersen
1   Department of Orthopaedics, University Clinic for Hand, Hip and Knee Surgery, Hospital Unit West, Holstebro, Denmark
2   Department of Clinical Medicine, Aarhus University, Aarhus N, Denmark
3   AutoRSA Research Group, Orthopaedic Research Unit, Aarhus University Hospital, Aarhus N, Denmark
,
Katriina Bøcker Puhakka
5   Department of Radiology, Aarhus University Hospital, Aarhus N, Denmark
6   Department of Radiology, Regional Hospital Horsens, Horsens, Denmark
,
Torben Bæk Hansen
1   Department of Orthopaedics, University Clinic for Hand, Hip and Knee Surgery, Hospital Unit West, Holstebro, Denmark
2   Department of Clinical Medicine, Aarhus University, Aarhus N, Denmark
,
Maiken Stilling
2   Department of Clinical Medicine, Aarhus University, Aarhus N, Denmark
3   AutoRSA Research Group, Orthopaedic Research Unit, Aarhus University Hospital, Aarhus N, Denmark
7   Department of Orthopaedic Surgery, Aarhus University, Aarhus N, Denmark
› Author Affiliations Funding This research has received grants from Health Research Fund of Central Denmark Region, Aarhus University, The Danish Rheumatism Association and Innovation Fund Denmark (Grant 69-2013-1). All funding sources did not play a role in the study investigation.
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Abstract

Background Measurement of in vivo distal radioulnar joint (DRUJ) pathomechanics during simple activities can represent the disability experienced by patients and may be useful in diagnostics of DRUJ instability. A first step is to describe the physiological normal limits for DRUJ kinematics in a reproducible and precise test setup, which was the aim of this study.

Methods DRUJ kinematics were evaluated in 33 participants with dynamic radiostereometry (RSA) while performing a standardized press test examination. AutoRSA software was used for image analyses. Computed tomography (CT) forearm bone models were generated, and standardized anatomical axes were applied to estimate kinematic outcomes including, DRUJ translation, DRUJ position ratio, and changes in ulnar variance. Repeatability of dynamic RSA press test double examinations was evaluated to estimate the precision and intraclass correlation coefficient (ICC) test–retest agreement.

Results The maximum force during the press test was 6.0 kg (95% confidence interval [CI]: 5.1–6.9), which resulted in 4.7 mm (95% CI: 4.2–5.1) DRUJ translation, DRUJ position ratio of 0.40 (95% CI: 0.33–0.44), and increase in ulnar variance of 1.1 mm (95% CI: 1.0–1.2). The mean maximum DRUJ translation leveled off after a 5 kg force application. The DRUJ translation ICC coefficient was 0.93 within a prediction interval of ± 0.53mm.

Conclusions This clinical study demonstrates the normal values of DRUJ kinematics and reports excellent agreement and high precision of the press tests examination using an automated noninvasive dynamic RSA imaging method based on patient-specific CT bone models. The next step is the application of the method in patients with arthroscopic verified triangular fibrocartilage complex injuries.

Level of Evidence This is a Level IV, case series study.

Keywords

radioulnar ligaments - distal radioulnar joint - normal values - radiostereometry - joint kinematics

Note

The institutions at Which the work was performed were Department of Orthopaedics, University Clinic for Hand, Hip and Knee Surgery, Hospital Unit West, Lægaardvej 12, 7500 Holstebro, Denmark and Department of Orthopaedic Surgery, Aarhus University, Palle Juul-Jensens Boulevard 165, 8200 Aarhus N, Denmark


Ethical Approval

The Danish Data Protection Agency (Journal no.2012–58–006; issued May 2016) and The Central Denmark Region Committees on Health Research Ethics (Journal no.1–10–72–146–16; issued August 2016) approved the study. Informed consent was obtained from the participating subjects.




Publication History

Received: 02 June 2021

Accepted: 09 November 2021

Article published online:
27 December 2021

© 2021. Thieme. All rights reserved.

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