本研究旨在結合動態電腦斷層掃描影像與個體化有限元素模型，建立一套以最佳化演算法逆向求取拇指腕掌（trapeziometacarpal, TMC）關節五條主要韌帶剛度之方法，量化不同個案之韌帶力學特性。 在此基礎上，進一步選取單一個案之生物力學模型與反推韌帶參數，進行關節應力分析，系統性模擬韌帶弱化與關節軟骨磨損等退化性關節炎相關病理機制，評估其對軟骨負荷與接觸應力分布的影響，並探討不同韌帶重建手術情境是否有助於緩和關節軟骨之應力集中。
實驗共招募 12 位健康右手慣用之受試者，於雙源電腦斷層掃描儀下進行一組靜態 CT 與多組動態 4DCT 掃描，同步使用客製化力學量測系統記錄四種標準化受力姿勢（MP、UMCH、DMCH、DMCB）下的施力時間歷程。影像經分割與配準後重建大多角骨、第一掌骨與第二掌骨幾何，並結合 SLB-50 感測器位置與受力資訊，建立個體化 TMC 關節有限元素模型，設定骨骼與韌帶之材料性質與邊界條件。進一步以各姿勢之實測力—位移資料作為目標，透過粒子群最佳化迭代計算，反推每位受試者五條主要韌帶的等效剛度，再於單一個案模型中加入關節軟骨元素，比較正常與磨損軟骨的接觸應力分布，並系統性削弱各韌帶剛度，以評估其在不同姿勢下的關鍵穩定功能。
研究成果發現經最佳化後的韌帶剛度數值，是以 DCL 與 DRL 為最大，符合近期文獻的觀點。進一步的姿勢分析證實，不同動作下主導關節穩定性的韌帶有所差異；在軟骨磨損（厚度減少）情境中，多數姿勢的應力峰值與平均應力皆明顯升高。此外，本研究亦發現，多數姿勢在進行韌帶重建手術後，其關節應力峰值與平均應力皆有下降趨勢，顯示適當的重建張力有助於改善軟骨受力環境。

This study developed a subject–specific finite element framework to investigate ligament mechanics and cartilage stresses in the trapeziometacarpal (TMC) joint. In vitro loading experiments were performed on 12 healthy volunteers using a customized stress–view system and dynamic computed tomography to capture joint kinematics under four functional postures. Segmented and registered bone models of the trapezium, first, and second metacarpals were imported into an FE platform, where the five primary TMC ligaments were represented as connector elements and experimental loads and displacements were applied.
A tailored particle swarm optimization algorithm was employed to inversely identify equivalent stiffness values for each ligament in every subject. The dorsal ligaments, DCL and DRL, consistently exhibited the highest stiffness and the greatest inter–subject variability, while the anterior oblique ligament ranked third, highlighting the dominant yet heterogeneous role of dorsal stabilizers. A representative subject was then used for cartilage contact analysis with a hyperelastic cartilage model to evaluate the combined effects of posture, ligament laxity, cartilage thinning, and surgical reconstruction.
Posture–specific stabilizer ligaments were identified, and selective laxity of these ligaments markedly increased peak and mean cartilage stresses by shifting load to the articular surface. Cartilage wear alone, modeled as a 40% reduction in thickness, substantially elevated stresses, and its combination with ligament laxity produced additive stress amplification. These findings suggest that ligamentous stability and cartilage integrity must be jointly balanced when planning ligament release, reconstruction, or rehabilitation strategies for TMC osteoarthritis.

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