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BMC Musculoskeletal Disorders
Published in: BMC Musculoskeletal Disorders 1/2020

Open Access 01-12-2020 | Research article

A finite element analysis of sacroiliac joint displacements and ligament strains in response to three manipulations

Authors: Zhun Xu, Yikai Li, Shaoqun Zhang, Liqing Liao, Kai Wu, Ziyu Feng, Dan Li

Published in: BMC Musculoskeletal Disorders | Issue 1/2020

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Abstract

Background

Clinical studies have found that manipulations have a good clinical effect on sacroiliac joint (SIJ) pain without specific causes. However, the specific mechanisms underlying the effect of manipulations are still unclear. The purpose of this study was to investigate the effects of three common manipulations on the stresses and displacements of the normal SIJ and the strains of the surrounding ligaments.

Methods

A three-dimensional finite element model of the pelvis-femur was developed. The manipulations of hip and knee flexion (MHKF), oblique pulling (MOP), and lower limb hyperextension (MLLH) were simulated. The stresses and displacements of the SIJ and the strains of the surrounding ligaments were analyzed during the three manipulations.

Results

MOP produced the highest stress on the left SIJ, at 6.6 MPa, while MHKF produced the lowest stress on the right SIJ, at 1.5 MPa. The displacements of the SIJ were all less than 1 mm during the three manipulations. The three manipulations caused different degrees of ligament strain around the SIJ, and MOP produced the greatest straining of the ligaments.

Conclusion

The three manipulations all produced small displacements of the SIJ and different degrees of ligament strains, which might be the mechanism through which they relieve SIJ pain. MOP produced the largest displacement and the greatest ligament strains.
Literature
1.
Cohen SP. Sacroiliac joint pain: a comprehensive review of anatomy, diagnosis, and treatment. Anesth Analg. 2005;101(5):1440–53.
2.
Joukar A, Shah A, Kiapour A, Vosoughi AS, Duhon B, Agarwal AK, et al. Sex specific sacroiliac ioint biomechanics during standing upright: a finite element study. Spine. 2018;43(18):e1053–e60.
3.
Wu T, Ren X, Cui Y, Cheng X, Peng S, Hou Z, et al. Biomechanical study of three kinds of internal fixation for the treatment of sacroiliac joint disruption using biomechanical test and finite element analysis. J Orthop Surg Res. 2018;13(1):152.PubMedCentral
4.
Yang XW, Chen ZJ, Zhang SQ, Zhang MC, Li YK. A three-dimensional finite element analysis of sacroiliac joint exerted simulating oblique-pulling manipulation. J Pract Med. 2014;30(14):2228–30.
5.
Al-Subahi M, Alayat M, Alshehri MA, Helal O, Alhasan H, Alalawi A, et al. The effectiveness of physiotherapy interventions for sacroiliac joint dysfunction: a systematic review. J Phys Ther Sci. 2017;29(9):1689–94.PubMedCentral
6.
Liang SH, Ye GH, Chen HL, Liu XH, Li YK. Clinical study of sacroiliac joint subluxation. Chin J Rehabil Med. 2007;22(2):172–3.
7.
Shi D, Wang F, Wang D, Li X, Wang Q. 3-D finite element analysis of the influence of synovial condition in sacroiliac joint on the load transmission in human pelvic system. Med Eng Phys. 2014;36(6):745–53.
8.
Rothkötter HJ, Berner W. Failure load and displacement of the human sacroiliac joint under in vitro loading. Arch Orthop Trauma Surg. 1988;107(5):283–7.
9.
Aihara T, Takahashi K, Yamagata M, Moriya H, Shimada Y. Does the iliolumbar ligament prevent anterior displacement of the fifth lumbar vertebra with defects of the pars? J Bone Joint Surg Br Vol. 2000;82(6):846–50.
10.
Vleeming A, Van Wingerden JP, Dijkstra PF, Stoeckart R, Snijders CJ, Stijnen T. Mobility in the sacroiliac joints in the elderly: a kinematic and radiological study. Clin Biomechanics (Bristol, Avon). 1992;7(3):170–6.
11.
Dujardin FH, Roussignol X, Hossenbaccus M, Thomine JM. Experimental study of the sacroiliac joint micromotion in pelvic disruption. J Orthop Trauma. 2002;16(2):99–103.
12.
Kim YH, Yao Z, Kim K, Park WM. Quantitative investigation of ligament strains during physical tests for sacroiliac joint pain using finite element analysis. Man Ther. 2014;19(3):235–41.
13.
Lindsey DP, Perez-Orribo L, Rodriguez-Martinez N, Reyes PM, Newcomb A, Cable A, et al. Evaluation of a minimally invasive procedure for sacroiliac joint fusion-an in vitro biomechanical analysis of initial and cycled properties. Med Devices (Auckland, NZ). 2014;7:131–7.
14.
Schuit D, McPoil TG, Mulesa P. Incidence of sacroiliac joint malalignment in leg length discrepancies. J Am Podiatr Med Assoc. 1989;79(8):380–3.
15.
Cody JP, Kang DG, Lehman RA. Combat-related lumbopelvic dissociation treated with percutaneous sacroiliac screw placement. Spine J. 2012;12(9):858–9.
16.
Fu S, Zhao Y, Lian W, Zou D, Sun T, Zhao Y, et al. Comparison of the risk of breakage of two kinds of sacroiliac screws in the treatment of bilateral sacral fractures. Eur Spine J. 2014;23(7):1558–67.
17.
Shui X, Ying X, Mao C, Feng Y, Chen L, Kong J, et al. Percutaneous screw fixation of crescent fracture-dislocation of the sacroiliac joint. Orthopedics. 2015;38(11):e976–82.
18.
Zhou YJ, Yunus A, Tian Z, Chen JT, Wang C, Xu LL, et al. The pedicle screw-rod system is an acceptable method of reconstructive surgery after resection of sacroiliac joint tumours. Contemporary Oncol (Poznan, Poland). 2016;20(1):73–9.
19.
Cleland JA, Fritz JM, Kulig K, Davenport TE, Eberhart S, Magel J, et al. Comparison of the effectiveness of three manual physical therapy techniques in a subgroup of patients with low back pain who satisfy a clinical prediction rule. Spine. 2009;34(25):2720–9.PubMedCentral
20.
Nejati P, Safarcherati A, Karimi F. Effectiveness of exercise therapy and manipulation on sacroiliac joint dysfunction: a randomized controlled trial. Pain Phys. 2019;22(1):53–61.
21.
Kamali F, Shokri E. The effect of two manipulative therapy techniques and their outcome in patients with sacroiliac joint syndrome. J Bodyw Mov Ther. 2012;16(1):29–35.
22.
Luan L, Wen YK. Treatment of sacroiliac joint dislocation with bone setting manipulation. China J Orthop Traumatol. 2009;22(04):311–3.
23.
Huang JN, He YF, Liu H, He ZT, Wu BJ, Zhao XY. Diagnosis, treatment and research advances of sacroiliac joint dislocation. Chin J Tissue Eng Res. 2019;23(20):3201–6.
24.
Fan CZ. The review of traumatic sacroiliac joint subluxation. Infromation Tradit Chin Med. 1984;02:39–41.
25.
Liu JX, Huang Y, Zhang H, Chen X. Diagnosis and treatment of the subluxation of sacroiliac joint. J Cervicodynia Lumbodynia. 2000;02:118–20.
26.
Tullberg T, Blomberg S, Branth B, Johnsson R. Manipulation does not alter the position of the sacroiliac joint. A roentgen stereophotogrammetric analysis. Spine. 1998;23(10):1124–8.
27.
Wang XC, Xiao HE, Wang XB. Three-step combined manipulation for the treatment of 132 cases of sacroiliac joint misalignment. Chin J Tradit Med Traumatol Orthop. 2011;19(06):40–1.
28.
Lee CH, Hsu CC, Huang PY. Biomechanical study of different fixation techniques for the treatment of sacroiliac joint injuries using finite element analyses and biomechanical tests. Comput Biol Med. 2017;87:250–7.
29.
Xu F, Hou WL. Two kinds of therapeutic methods and effectiveness observation in acute sacroiliac joint injury. Chin J Tradit Med Traumatol Orthop. 2003;11(5):6–8.
30.
Bao XR, Wang Q, Peng L, Yu J. Modified inclined pulling manipulation in treatment of disorders of sacroiliac joint. Chin Gen Prac. 2013;16(3):310–1.
31.
Zhang QH, Wang JY, Lupton C, Heaton-Adegbile P, Guo ZX, Liu Q, et al. A subject-specific pelvic bone model and its application to cemented acetabular replacements. J Biomech. 2010;43(14):2722–7.
32.
Miller JA, Schultz AB, Andersson GB. Load-displacement behavior of sacroiliac joints. J Orthop Res. 1987;5(1):92–101.
33.
Eichenseer PH, Sybert DR, Cotton JR. A finite element analysis of sacroiliac joint ligaments in response to different loading conditions. Spine. 2011;36(22):E1446–52.
34.
Walker JM. The sacroiliac joint: a critical review. Phys Ther. 1992;72(12):903–16.
35.
Wilke HJ, Fischer K, Jeanneret B, Claes L, Magerl F. In vivo measurement of 3-dimensional movement of the iliosacral joint. Zeitschrift fur Orthopadie und ihre Grenzgebiete. 1997;135(6):550–6.
36.
Sichting F, Rossol J, Soisson O, Klima S, Milani T, Hammer N. Pelvic belt effects on sacroiliac joint ligaments: a computational approach to understand therapeutic effects of pelvic belts. Pain Phys. 2014;17(1):43–51.
37.
Bohme J, Lingslebe U, Steinke H, Werner M, Slowik V, Josten C, et al. The extent of ligament injury and its influence on pelvic stability following type II anteroposterior compression pelvic injuries-a computer study to gain insight into open book trauma. J Orthop Res. 2014;32(7):873–9.
38.
Szadek KM, Hoogland PV, Zuurmond WW, De Lange JJ, Perez RS. Possible nociceptive structures in the sacroiliac joint cartilage: An immunohistochemical study. Clin Anatomy (New York, NY). 2010;23(2):192–8.
39.
Chen ZJ, Yang XW, Xiang XB. 3D finite element anaIysis on pelvic under compressing manipulation by flexing hip and knee. J Med Biomechanics. 2015;30(3):233–7.
40.
Ivanov AA, Kiapour A, Ebraheim NA, Goel V. Lumbar fusion leads to increases in angular motion and stress across sacroiliac joint: a finite element study. Spine. 2009;34(5):E162–9.
Metadata
Title
A finite element analysis of sacroiliac joint displacements and ligament strains in response to three manipulations
Authors
Zhun Xu
Yikai Li
Shaoqun Zhang
Liqing Liao
Kai Wu
Ziyu Feng
Dan Li
Publication date
01-12-2020
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2020
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/s12891-020-03735-y

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