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Toyohara R, Ohashi T. A literature review of biomechanical studies on physiological and pathological sacroiliac joints: Articular surface structure, joint motion, dysfunction and treatments. Clin Biomech (Bristol, Avon) 2024; 114:106233. [PMID: 38531152 DOI: 10.1016/j.clinbiomech.2024.106233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 03/19/2024] [Accepted: 03/20/2024] [Indexed: 03/28/2024]
Abstract
BACKGROUND Sacroiliac joints are affected by mechanical environments; the joints are formed under mechanical stimulation, receive impact of walking between the upper and lower parts of the bodies and can be a cause of pain due to non-physiological loads. However, there are so far very few studies that reviewed biomechanics of physiological and pathological sacroiliac joints. This review article aims to describe the current sacroiliac joint biomechanics. METHODS Previous original papers have been summarized based on three categories: articular surface structure, sacroiliac joint motion and sacroiliac joint dysfunction and treatments. FINDINGS Although the articular surface morphologies vary greatly from individual to individual, many researchers have tried to classify the joints into several types. It has been suggested that the surface morphologies may not change regardless of joint dysfunction, however, the relationship between the joint structure and pain are still unclear. The range of sacroiliac joint motion is demonstrated to be less than 1 mm and there is no difference between physiological and pathological joints. The sacroiliac joint absorbs shock within the pelvis by the joint structures of pelvic morphology, ligaments and fat tissues. The morphology and motion of the sacroiliac joints may be optimized for upright bipedal walking. INTERPRETATION There is no doubt that pelvic mechanical environments affect pain induction and treatment; however, no one has yet provided a concrete explanation. Future research could help develop treatments based on sacroiliac joint biomechanics to support joint function.
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Affiliation(s)
- Ryota Toyohara
- Faculty of Engineering, Hokkaido University, Japan; Creative Research Institution, Hokkaido University, Japan.
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Pallua JD, Pallua AK, Streif W, Spiegl H, Halder C, Arora R, Schirmer M. Long-Term Comparison of Two- and Three-Dimensional Computed Tomography Analyses of Cranial Bone Defects in Severe Parietal Thinning. Diagnostics (Basel) 2024; 14:446. [PMID: 38396485 PMCID: PMC10887978 DOI: 10.3390/diagnostics14040446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 02/13/2024] [Accepted: 02/15/2024] [Indexed: 02/25/2024] Open
Abstract
Parietal thinning was detected in a 72-year-old with recurrent headaches. Quantification of bone loss was performed applying two- and three-dimensional methods using computerized tomographies. Two-dimensional methods provided accurate measurements using single-line analyses of bone thicknesses (2.13 to 1.65 and 1.86 mm on the left and 4.44 to 3.08 and 4.20 mm on the right side), single-point analyses of bone intensities (693 to 375 and 403 on the left and 513 to 393 and 411 Houndsfield Units on the right side) and particle-size analyses of low density areas (16 to 22 and 12 on the left and 18 to 23 and 14 on the right side). Deteriorations between days 0 and 220 followed by bone stability on day 275 were paralleled using the changed volumes of bone defects to 1200 and finally 1133 mm3 on the left side and to 331 and finally 331 mm3 on the right side. Interfolding as measurement of the bones' shape provided changes to -1.23 and -1.72 mm on the left and to -1.42 and -1.30 mm on the right side. These techniques suggest a stabilizing effect of corticosteroids between days 220 and 275. Reconstruction of computerized tomographies appears justified to allow for quantification of bone loss during long-term follow-up.
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Affiliation(s)
- Johannes Dominikus Pallua
- Department of Orthopaedics and Traumatology, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria;
| | - Anton Kasper Pallua
- Former Institute for Computed Tomography-Neuro CT, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria;
| | - Werner Streif
- Department of Pediatrics I, Medical University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria;
| | - Harald Spiegl
- WESTCAM Datentechnik GmbH, Gewerbepark 38, 6068 Mils, Austria; (H.S.); (C.H.)
| | - Clemens Halder
- WESTCAM Datentechnik GmbH, Gewerbepark 38, 6068 Mils, Austria; (H.S.); (C.H.)
| | - Rohit Arora
- Department of Orthopaedics and Traumatology, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria;
| | - Michael Schirmer
- Department of Internal Medicine, Clinic II, Medical University of Innsbruck, 6020 Innsbruck, Austria
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Toyohara R, Hammer N, Ohashi T. Experimental characterization of motion resistance of the sacroiliac joint. Biomed Mater Eng 2024; 35:53-63. [PMID: 37545208 DOI: 10.3233/bme-230041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/08/2023]
Abstract
BACKGROUND The human sacroiliac joint (SIJ) in vivo is exposed to compressive and shearing stress environment, given the joint lines are almost parallel to the direction of gravity. The SIJ supports efficient bipedal walking. Unexpected or unphysiological, repeated impacts are believed to cause joint misalignment and result in SIJ pain. In the anterior compartment of the SIJ being synovial, the articular surface presents fine irregularities, potentially restricting the motion of the joints. OBJECTIVE To clarify how the SIJ articular surface affects the resistance of the motion under physiological loading. METHODS SIJ surface models were created based on computed tomography data of three patients and subsequently 3D printed. Shear resistance was measured in four directions and three combined positions using a customized setup. In addition, repositionability of SIJs was investigated by unloading a shear force. RESULTS Shear resistance of the SIJ was the highest in the inferior direction. It changed depending on the direction of the shear and the alignment position of the articular surface. CONCLUSION SIJ articular surface morphology is likely designed to accommodate upright bipedal walking. Joint misalignment may in consequence increase the risk of subluxation.
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Affiliation(s)
- Ryota Toyohara
- Faculty of Engineering, Hokkaido University, Sapporo, Japan
| | - Niels Hammer
- Division of Clinical and Macroscopic Anatomy, Gottfried Schatz Research Center, Medical University of Graz, Graz, Austria
- Department of Orthopedic and Trauma Surgery, University of Leipzig, Leipzig, Germany
- Division of Biomechatronics, Fraunhofer Institute for Machine Tools and Forming Technology (IWU), Chemnitz, Germany
| | - Toshiro Ohashi
- Faculty of Engineering, Hokkaido University, Sapporo, Japan
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Poilliot A, Zeissloff L, Ondruschka B, Hammer N. Fat quantification in the sacroiliac joint syndesmosis: a new semi-automatic volumetric approach. Sci Rep 2023; 13:16930. [PMID: 37805640 PMCID: PMC10560246 DOI: 10.1038/s41598-023-44066-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 10/03/2023] [Indexed: 10/09/2023] Open
Abstract
Fat is physiologically embedded within the interosseous ligaments in the posterior part of the sacroiliac joint (PSIJ). This composite of fat and ligaments is hypothesized to serve a shock-absorbing, stabilizing function for the sacroiliac joint and the lumbopelvic transition region. Using a novel Python-based software (VolSEQ), total PSIJ volume and fat volume were computed semi-automatically. Differences within the cohort and the viability of the program for the quantification of fat in routine computed tomography (CT) scans were assessed. In 37 CT scans of heathy individuals, the PSIJ were first manually segmented as a region of interest in OSIRIX. Within VolSEQ, 'fat' Hounsfield units (- 150 to - 50 HU) are selected and the DICOM file of the patient scan and associated region of interest file from OSIRIX were imported and the pixel sub volumes were then automatically computed. Volume comparisons were made between sexes, sides and ages (≤ 30, 31-64 and > 65 years). PSIJ volumes in both software (VolSeq vs. OSIRIX) were non-different (both 9.7 ± 2.8cm3; p = 0.9). Total PSIJ volume (p = 0.3) and fat volume (p = 0.7) between sexes were non-different. A significant difference in total PSIJ volume between sexes (p < 0.01) but not in fat volume (p = 0.3) was found only in the ≥ 65 years cohort. Fat volume within the PSIJ remains unchanged throughout life. PSIJ volume is sex-dependent after 65 years. VolSEQ is a viable and user-friendly method for sub-volume quantification of tissues in CT.
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Affiliation(s)
- Amélie Poilliot
- Anatomical Institute, University of Basel, Pestalozzistrasse 20, 4056, Basel, Switzerland.
| | | | - Benjamin Ondruschka
- Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Niels Hammer
- Division of Macroscopic and Clinical Anatomy, Gottfried Schatz Research Center, Medical University of Graz, Auenbruggerplatz 25, Graz, Austria
- University Clinics, University of Leipzig, Leipzig, Germany
- Division of Biomechatronics, Fraunhofer Institute for Machine Tools and Forming Technology (IWU), Dresden, Germany
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Poilliot A, Hammer N, Toranelli M, Doyle T, Gay‐Dujak MH, Müller‐Gerbl M. Influence of size and shape of the auricular surfaces on subchondral bone density distribution in the sacroiliac joint. J Anat 2023; 243:475-485. [PMID: 36893752 PMCID: PMC10439371 DOI: 10.1111/joa.13857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 02/17/2023] [Accepted: 02/20/2023] [Indexed: 03/11/2023] Open
Abstract
The sacroiliac auricular surface has a variable morphology and size. The impact of such variations on subchondral mineralization distribution has not been investigated. Sixty-nine datasets were subjected to CT-osteoabsorptiometry for the qualitative visualization of chronic loading conditions of the subchondral bone plate using color-mapped densitograms based on Hounsfield Units in CT. Auricular surface morphologies were classified into three types based on posterior angle size: Type 1: >160°, Type 2: 130-160° and Type 3: <130°. Auricular surface size was categorized based on the mean value (15.4 cm2 ) separating the group into 'small' and 'large' joint surfaces. Subchondral bone density patterns were qualitatively classified into four color patterns: two marginal patterns (M1 and M2) and two non-marginal patterns (N1 and N2) and each iliac and sacral surface was subsequently categorized. 'Marginal' meant that 60-70% of the surface was less mineralized compared with the highly dense regions and vice versa for the 'non-marginal' patterns. M1 had anterior border mineralization and M2 had mineralization scattered around the borders. N1 had mineralization spread over the whole superior region, N2 had mineralization spread over the superior and anterior regions. Auricular surface area averaged 15.4 ± 3.6 cm2 , with a tendency for males to have larger joint surfaces. Type 2 was the most common (75%) and type 3 the least common morphology (9%). M1 was the most common pattern (62% of surfaces) by sex (males 60%, females 64%) with the anterior border as the densest region in all three morphologies. Sacra have a majority of surfaces with patterns from the marginal group (98%). Ilia have mineralization concentrated at the anterior border (patterns M1 and N2 combined: 83%). Load distribution differences related to auricular surface morphology seems to have little effect on long-term stress-related bone adaptation visualized with CT-osteoabsorptiometry. Higher iliac side mineralization was observed in larger joint surfaces and age-related morphomechanical size alterations were seen in males.
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Affiliation(s)
| | - Niels Hammer
- Division of Macroscopic and Clinical Anatomy, Gottfried Schatz Research CenterMedical University of GrazGrazAustria
- Department of Orthopedic and Trauma SurgeryUniversity of LeipzigLeipzigGermany
- Division of BiomechatronicsFraunhofer Institute for Machine Tools and Forming TechnologyDresdenGermany
| | | | - Terence Doyle
- University of Otago School of MedicineDunedinNew Zealand
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Poilliot A, Hammer N, Toranelli M, Gay MHP, Müller-Gerbl M. Auricular surface morphology and surface area does not influence subchondral bone density distribution in the dysfunctional sacroiliac joint. Clin Anat 2023; 36:447-456. [PMID: 36399231 DOI: 10.1002/ca.23980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 11/09/2022] [Accepted: 11/09/2022] [Indexed: 11/19/2022]
Abstract
The subchondral lamella of the sacroiliac auricular surface is morphologically inconsistent. Its morpho-mechanical relationship with dysfunction (SIJD) remains unstudied. Here, the iliac and sacral subchondral bone mineralization is compared between morphological subtypes and in large and small surfaces, in SIJD joints and controls. CT datasets from 29 patients with bilateral or unilateral SIJD were subjected to CT-osteoabsorptiometry. Surface areas and posterior angles were calculated and surfaces were classified by size: small (<15 cm3 ) and large (≥15 cm3 ), and morphological types: 1 (>160°), 2 (130°-160°), and 3 (<130°). Mineralization patterns were identified: two marginal (M1 and M2) and two non-marginal (N1 and N2). Each sacral and iliac surface was subsequently classified. Dysfunctional cohort area averaged 15.0 ± 2.4 cm2 (males 16.2 ± 2.5 cm2 , females 13.7 ± 1.6 cm2 ). No age correlations with surface area were found nor mean Hounsfield Unit differences when comparing sizes, sexes or morphology-type. Controls and dysfunctional cohort comparison revealed differences in female sacra (p = 0.02) and small sacra (p = 0.03). There was low-conformity in marginal and non-marginal patterns, 26% for contralateral non-dysfunctional joints, and 46% for dysfunctional joints. The majority of painful joints was of type 2 morphology (59%), equally distributed between small (49%) and large joints (51%). Larger joints had the highest frequency of dysfunctional joints (72%). Auricular surface morphology seems to have little impact on pain-related subchondral lamella adaptation in SIJD. Larger joints may be predisposed to the onset of pain due to the weakening of the extracapsular structures. Dysfunctional joints reflect common conformity patterns of sacral-apex mineralization with corresponding superior corner iliac mineralization.
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Affiliation(s)
- Amélie Poilliot
- Anatomical Institute, University of Basel, Basel, Switzerland
| | - Niels Hammer
- Division of Macroscopic and Clinical Anatomy, Gottfried Schatz Research Center, Medical University of Graz, Graz, Austria.,Department of Orthopaedic and Trauma Surgery, University of Leipzig, Leipzig, Germany.,Division of Biomechatronics, Fraunhofer Institute for Machine Tools and Forming Technology, Dresden, Germany
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Toyohara R, Kaneuji A, Takano N, Kurosawa D, Hammer N, Ohashi T. A patient-cohort study of numerical analysis on sacroiliac joint stress distribution in pre- and post-operative hip dysplasia. Sci Rep 2022; 12:14500. [PMID: 36008525 PMCID: PMC9411127 DOI: 10.1038/s41598-022-18752-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 08/18/2022] [Indexed: 12/01/2022] Open
Abstract
In acetabular dysplasia, the cartilaginous roof on the acetabular side does not fully cover the femoral head, which may lead to abnormal stress distribution in both the femoral head and pelvis. These stress changes may have implications to the adjacent sacroiliac joint (SIJ). The SIJ has a minimal range of motion and is closely coupled to the adjacent spine and pelvis. In consequence, the SIJ may react sensitively to changes in stress distribution at the acetabulum, with hypermobility-induced pain. The purpose of this study was to investigate the stress distribution of the SIJ in acetabular dysplasia, and to gain insight into the cause and mechanisms of hypermobility-induced pain at the SIJ. Finite element models of pre- and postoperative pelves of four patients with acetabular dysplasia were created and analyzed in double leg standing positions. The preoperative models were relatively inflare, the sacral nutation movement, SIJ cartilage equivalent stress, and the load on the surrounding ligaments decreased with increased posterior acetabular coverage. Acetabular morphology was shown to affect the SIJ, and improvement of the posterior acetabular coverage may help normalize load transmission of the pelvis and thus improve the stress environment of the SIJ in acetabular dysplasia.
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Affiliation(s)
- Ryota Toyohara
- Division of Human Mechanical Systems and Design, Graduate School of Engineering, Hokkaido University, N13, W8, Kita-ku, Hokkaido, Sapporo, 060-8628, Japan.
| | - Ayumi Kaneuji
- Department of Orthopedic Surgery, Kanazawa Medical University, Uchinada, Japan
| | - Noriyuki Takano
- Integrated Technology Research Center of Medical Science and Engineering, Kanazawa Institute of Technology, Nonoichi, Japan
| | - Daisuke Kurosawa
- Department of Orthopedic Surgery/Japan Sacroiliac Joint and Low Back Pain Center, JCHO Sendai Hospital, Sendai, Japan
| | - Niels Hammer
- Division of Macroscopic and Clinical Anatomy, Gottfried Schatz Research Center, Medical University of Graz, Graz, Austria.,Department of Orthopedic and Trauma Surgery, University of Leipzig, Leipzig, Germany.,Fraunhofer Institute for Machine Tools and Forming Technology (IWU), Medical Branch, Dresden, Germany
| | - Toshiro Ohashi
- Faculty of Engineering, Hokkaido University, Sapporo, Japan
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Serrano N, Kissling M, Krafft H, Link K, Ullrich O, Buck FM, Mathews S, Serowy S, Gascho D, Grüninger P, Fornaciari P, Bouaicha S, Müller-Gerbl M, Rühli FJ, Eppler E. CT-based and morphological comparison of glenoid inclination and version angles and mineralisation distribution in human body donors. BMC Musculoskelet Disord 2021; 22:849. [PMID: 34610804 PMCID: PMC8493698 DOI: 10.1186/s12891-021-04660-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Accepted: 08/25/2021] [Indexed: 11/11/2022] Open
Abstract
Background For optimal prosthetic anchoring in omarthritis surgery, a differentiated knowledge on the mineralisation distribution of the glenoid is important. However, database on the mineralisation of diseased joints and potential relations with glenoid angles is limited. Methods Shoulder specimens from ten female and nine male body donors with an average age of 81.5 years were investigated. Using 3D-CT-multiplanar reconstruction, glenoid inclination and retroversion angles were measured, and osteoarthritis signs graded. Computed Tomography-Osteoabsorptiometry (CT-OAM) is an established method to determine the subchondral bone plate mineralisation, which has been demonstrated to serve as marker for the long-term loading history of joints. Based on mineralisation distribution mappings of healthy shoulder specimens, physiological and different CT-OAM patterns were compared with glenoid angles. Results Osteoarthritis grades were 0-I in 52.6% of the 3D-CT-scans, grades II-III in 34.3%, and grade IV in 13.2%, with in females twice as frequently (45%) higher grades (III, IV) than in males (22%, III). The average inclination angle was 8.4°. In glenoids with inclination ≤10°, mineralisation was predominantly centrally distributed and tended to shift more cranially when the inclination raised to > 10°. The average retroversion angle was − 5.2°. A dorsally enhanced mineralisation distribution was found in glenoids with versions from − 15.9° to + 1.7°. A predominantly centrally distributed mineralisation was accompanied by a narrower range of retroversion angles between − 10° to − 0.4°. Conclusions This study is one of the first to combine CT-based analyses of glenoid angles and mineralisation distribution in an elderly population. The data set is limited to 19 individuals, however, indicates that superior inclination between 0° and 10°-15°, and dorsal version ranging between − 9° to − 3° may be predominantly associated with anterior and central mineralisation patterns previously classified as physiological for the shoulder joint. The current basic research findings may serve as basic data set for future studies addressing the glenoid geometry for treatment planning in omarthritis. Supplementary Information The online version contains supplementary material available at 10.1186/s12891-021-04660-4.
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Affiliation(s)
- Nabil Serrano
- Institute of Evolutionary Medicine (IEM), University of Zurich, Zurich, Switzerland
| | - Marc Kissling
- Institute of Anatomy, University of Bern, Bern, Switzerland
| | - Hannah Krafft
- Division of Gross Anatomy, Institute of Anatomy, University of Zurich, Zurich, Switzerland
| | - Karl Link
- Division of Gross Anatomy, Institute of Anatomy, University of Zurich, Zurich, Switzerland.,Anatomy, University of Fribourg, Fribourg, Switzerland
| | - Oliver Ullrich
- Division of Gross Anatomy, Institute of Anatomy, University of Zurich, Zurich, Switzerland
| | - Florian M Buck
- Medical Radiology Institute, Schulthess Clinic, Zurich, Switzerland
| | - Sandra Mathews
- Institute of Evolutionary Medicine (IEM), University of Zurich, Zurich, Switzerland
| | - Steffen Serowy
- Clinic of Neuroradiology, University Hospital of Magdeburg, Magdeburg, Germany
| | - Dominic Gascho
- Institute of Forensic Medicine, University of Zurich, Zurich, Switzerland
| | | | - Paolo Fornaciari
- Department of Orthopaedics, Balgrist University Hospital, Zurich, Switzerland.,Department of Orthopaedic Surgery and Traumatology, University Hospital Fribourg, Fribourg, Switzerland
| | - Samy Bouaicha
- Department of Orthopaedics, Balgrist University Hospital, Zurich, Switzerland
| | - Magdalena Müller-Gerbl
- Musculoskeletal Research, Department of Biomedicine, University of Basel, Basel, Switzerland
| | - Frank-Jakobus Rühli
- Institute of Evolutionary Medicine (IEM), University of Zurich, Zurich, Switzerland.
| | - Elisabeth Eppler
- Musculoskeletal Research, Department of Biomedicine, University of Basel, Basel, Switzerland. .,Clinic of Neuroradiology, University Hospital of Magdeburg, Magdeburg, Germany. .,Institute of Anatomy, University of Bern, Bern, Switzerland.
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