A finite element analysis of sacroiliac joint displacements and ligament strains in response to three manipulations
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RESEARCH ARTICLE
Open Access
A finite element analysis of sacroiliac joint displacements and ligament strains in response to three manipulations Zhun Xu1,2, Yikai Li1*, Shaoqun Zhang1,3, Liqing Liao1, Kai Wu1, Ziyu Feng1 and Dan Li1
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. Keywords: Manipulation, Sacroiliac joint, Displacement, Ligament strain, Finite element analysis
Background The sacroiliac joint (SIJ) is the largest axial joint in the human body; it connects the spine and the lower limbs and transmits the weight of the upper body to the pelvis and lower limbs [1–3]. The SIJ is composed of an anterior synovial part and a tightly connected ligament part at the rear [4, 5]. The sacrum is wedge-shaped, tilted from top to bottom and with a concave surface that is closely inserted into the convex surface of the ilium [6, 7]. It * Correspondence: [email protected] 1 School of Traditional Chinese Medicine, Southern Medical University, No. 1838, Guangzhou Avenue North, BaiYun District, Guangzhou 510515, Guangdong Province, China Full list of author information is available at the end of the article
includes some strong intrinsic and extrinsic ligaments [8, 9]. Due to its special anatomical structure, the SIJ is very stable [10–12]. However, certain bone or soft tissue lesions can cause joint instability, which subsequently induces SIJ pain. Recent studies have found that SIJ diseases can also cause low back pain and account for approximately 14.5–22.5% of cases [13]. The causes of SIJ pain include pathological bone destruction, traumatic fracture and dislocation, and pain without specific causes [5]. Commonly, abnormal gait, heavy physical exertion, leg length discrepancy, inflammation
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