Biomechanical Study of Ligaments Around the Elbow Joint

Regan, William D.; Korinek, S.; Morrey, B.F.; An, Kai-Nan

doi:10.1097/00003086-199110000-00023

Cited by 401 publications

(231 citation statements)

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“…In the normally functioning elbow, the anterior band of the medial ulnar collateral ligament (MUCL) provides the primary stabilization against valgus force [6,12,16,23,32]. Transection of the anterior bundle alone is sufficient to create demonstrable instability on the application of a valgus force and abnormally high radiocapitellar pressures [28].…”

Section: Introductionmentioning

confidence: 99%

Is a Silastic Radial Head Still a Reasonable Option?

Maghen

Leo

Hsu

et al. 2011

Clinical Orthopaedics &Amp; Related Research

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Background The importance of the radial head to elbow function and stability is increasingly apparent. Although preservation of the native radial head is preferred, severely comminuted fractures may necessitate resection or arthroplasty. Silastic radial head arthroplasty has been condemned on the basis of several sporadic reports of silicone synovitis. However, problems of ''overstuffing,'' cartilage wear, and motion loss are becoming apparent with metal prostheses, indicating this also is not an ideal solution. Thus, the choices remain controversial. Questions/purposes We asked whether intact or reconstructed primary elbow stabilizers permit use of silastic radial head implants without fragmentation, failure, and silicone synovitis. Methods We retrospectively reviewed 23 patients with unreconstructable radial head fractures who were treated with silastic radial head arthroplasty and concomitant repair and/or reconstruction of the medial ulnar collateral ligament and/or lateral ulnar collateral ligament. Analysis included range of motion, pain, stability, and radiographic assessments; Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire; and Mayo Elbow Performance Score (MEPS). The minimum followup was 16 months (average, 69.6 months; range, 16-165 months). Results At last followup, the mean elbow flexion was 145°, extension 11°, supination 80°, and pronation 83°. The mean MEPS score was 88.9. The mean DASH score was 11.8. There were eight reoperations, none resulting from failure of the radial head implants. Conclusions These results demonstrate silastic radial heads can be used with low complication rates and without evidence of synovitis when concomitant elbow ligament repair or reconstruction is performed.

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Section: Introductionmentioning

confidence: 99%

Is a Silastic Radial Head Still a Reasonable Option?

Maghen

Leo

Hsu

et al. 2011

Clinical Orthopaedics &Amp; Related Research

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“…It seems logical and justified, that all others nonoperative methods should be considered, before surgery treatment (Gao 2009). Cooperation between several scientific fields should bring further progress in the future (Riek et al 1999, Elliot et al 2004, Hatch et al 2006, Regan et al 1991, Blackwell & Cole 1994, Reid et al 2007, Wittek et al 2007. In order to achieve these goals, Model characteristics of all elementary techniques should be perfoprmed (Djurovic et al 2008).…”

Section: Discussionmentioning

confidence: 99%

A Unique Case of Supraspinatus Tendonitis after Tennis Forehand Repetitive Motions

Djurovic

Hraste

Stanisic

et al. 2010

Journal of Human Kinetics

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“…The linear region increases at a constant rate with the application of forces to the ligament. Table 3.3 came from published literature (Fisk & Wayne, 2009;Regan, Korinek, Morrey, & An, 1991;Spratley & Wayne, 2011) A damping coefficient of 0.5 Ns/mm was included in each spring element to remove the possibility of high frequency vibration during simulation (Guess, 2012). The triceps tendon was also modeled as a single bundle nonlinear spring damper element using a stiffness parameter (0.2 N/mm) obtained from Tate (2012).…”

Section: Multibody Model Formulationsmentioning

confidence: 99%

Development and validation of a computational multibody model of the elbow joint

Rahman

2014

Advances in biomechanics and applications

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Computational multibody models of the elbow joint can provide a powerful tool to study joint biomechanics, examine muscle and ligament function, soft tissue loading, and the effects of joint trauma. Such models can reduce the cost of expensive experimental testing and can predict some parameters that are difficult to investigate experimentally, such as forces within ligaments and contact forces between cartilage covered bones. These parameters can assist surgeons and other investigators to develop better treatments for elbow injuries and thereby increase patient care. Biomechanical computational models of the elbow exist in the literature, but these models are typically limited in their applicability by artificially constraining the joint (e.g. modeling the elbow as a hinge joint), prescribing specific kinematics, simplifying ligament characteristics or ignoring cartilage geometries.The purpose of this thesis was to develop anatomically correct subject specific computational multibody models of elbow joints and validate these models against experimental data. In these models, the joints were constrained by three-dimensional deformable contacts between articulating geometries, passive muscle loading, and multiple bundles of non-linear ligaments wrapped around the bones. iv In this approach, three-dimensional bone geometries for the model were constructed from volume images generated by computed tomography (CT) scans obtained from cadaver elbows. The ligaments and triceps tendon were modeled as spring-damper elements with non-linear stiffness. Articular cartilage was represented as uniform thickness solids covering the articulating bone surfaces. Finally, the model was validated by placing the cadaver elbows in a mechanical testing apparatus and comparing predicted kinematics and triceps tendon forces to experimentally measured values. A small improvement in predicted kinematics was observed compared to experimental values when the lateral ulnar collateral and annular ligament were wrapped around the bone. Some reductions of RMS error were also observed when a non-linear toe region was modeled in the ligament compared to models that had only a linear force-displacement relationship. None of these changes were statistically significant (ANOVA p-value was greater than 0.05).

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Biomechanical Study of Ligaments Around the Elbow Joint

Cited by 401 publications

References 0 publications

Is a Silastic Radial Head Still a Reasonable Option?

Is a Silastic Radial Head Still a Reasonable Option?

A Unique Case of Supraspinatus Tendonitis after Tennis Forehand Repetitive Motions

Development and validation of a computational multibody model of the elbow joint

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