Development of an active elbow flexion simulator to evaluate joint kinematics with the humerus in the horizontal position

Ferreira, Louis M.; Johnson, James A.; King, Graham J.W.

doi:10.1016/j.jbiomech.2010.04.007

Cited by 37 publications

(17 citation statements)

References 28 publications

(44 reference statements)

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“…21e23 Simulated muscle activation using this simulator has been shown to resist the gravity moment during active motion compared to passive motion. 17 However in this study, simulated muscle activation was unable to overcome the large moment on the elbow due to gravity in the varus and valgus orientations, resulting in elbow subluxation, dislocation, and coronoid fractures. This was certainly due to the instability caused by the induced collateral ligament injuries.…”

Section: Discussionmentioning

confidence: 80%

Rehabilitation of the Medial- and Lateral Collateral Ligament-deficient Elbow: An In Vitro Biomechanical Study

Alolabi¹,

Gray²,

Ferreira³

et al. 2012

Journal of Hand Therapy

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Section: Discussionmentioning

confidence: 80%

Rehabilitation of the Medial- and Lateral Collateral Ligament-deficient Elbow: An In Vitro Biomechanical Study

Alolabi¹,

Gray²,

Ferreira³

et al. 2012

Journal of Hand Therapy

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“…Those loads were used to ensure that the closed-loop load feedback controller did not allow slack within the tendons during motion. 29,30 This flexion-extension test was repeated for each finger (index, middle, and ring) in each wrist position (neutral, 30 flexed, and 30 extended). After all intact active finger motion simulations, a longitudinal incision was made along the length of the volar surface of the digit 1 cm proximal to the MCP joint and 1 cm distal to the DIP joint to identify the pulleys.…”

Section: Methodsmentioning

confidence: 99%

The Effect of Wrist Position on Finger Tendon Loads Following Pulley Sectioning and Operative Reconstruction

Haddara

Byers

Chinchalkar

et al. 2019

Journal of Hand Surgery Global Online

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Postoperative rehabilitation is important for maximizing patient outcomes after surgical pulley reconstruction. The purpose of this study was to identify the optimal wrist position in which rehabilitation should be undertaken to decrease the load on surgically reconstructed pulleys. Methods: We tested 14 digits composed of the index, middle, and ring fingers from 5 cadaveric specimens in a novel in vitro finger motion simulator designed to achieve full finger flexion and extension actively. Servo-motors were used to generate motion through tendons under load or position control while measuring tendon forces, joint range of motion, and tendon excursion. Flexor digitorum profundus (FDP) and flexor digitorum superficialis loads were measured sequentially with native intact pulleys and A2 and A4 pulleys sectioned, and with reconstructed A2 and A4 pulleys. Each condition was tested with the wrist neutral and with 30 wrist flexion or extension. The effect of wrist position on FDP and flexor digitorum superficialis loads under each condition was analyzed using repeated-measures analysis of variance. Results: With pulleys reconstructed, the wrist position had a significant effect on tendon load. The flexed wrist position resulted in a 31% reduction of FDP load compared with the neutral wrist position. Wrist extension also produced an apparent reduction of 14%, although not statistically significant. Conclusions: After pulley repair, placing the wrist in 30 flexion decreased tension in the FDP tendon compared with a neutral wrist. Clinical relevance: This study suggests that rehabilitation should be carried out with the wrist flexed to reduce the load on pulley reconstructions.

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“…This in vitro study used 8 fresh, previously frozen cadaveric arms (60.9 AE 18.2 years, 8 men) and a previously described elbow motion simulator. 11 A computed tomography (CT) scan (GE Lightspeed VCT 64 slice CT scanner; General Electric, New Berlin, WI) of each arm was performed to screen for deformity, previous trauma, or arthritis.…”

Section: Methodsmentioning

confidence: 99%

Effect of Radial Neck Length on Joint Loading

Berkmortel

Gladwell

et al. 2019

Journal of Shoulder and Elbow Arthroplasty

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Introduction: Load transfer across the radiocapitellar joint of the elbow is poorly understood both in the setting of the native radial head and following radial head arthroplasty. The purpose of this in vitro study was to determine the effects of radial neck length, arm position, and lateral collateral ligament (LCL) repair on radial load. Methods: A uniaxial load cell was implanted into the radial neck of 8 cadaveric specimens that were mounted on an in vitro motion-control simulator and tested (in dependent, varus, and valgus arm orientations) with the native radial neck length and then À4 to þ4 mm lengths. Testing was performed with the LCL intact and after sectioning and repair. Results: There was no significant difference between the 2 LCL states (P ¼.82), and LCL state was not protective of proximal radius overlengthening. Radial loads increased with increasing radial length (P <.001). Discussion and Conclusion: Overlengthening the radial neck resulted in higher compression forces, and underlengthening produced tensile forces, demonstrating that restoration of correct radial length during radial head arthroplasty is important to restore physiologic loading. In the varus position, tensile loading occurred, which may explain clinical problems with ingrowth of uncemented radial head implant stems and dissociation of bipolar implants.

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Development of an active elbow flexion simulator to evaluate joint kinematics with the humerus in the horizontal position

Cited by 37 publications

References 28 publications

Rehabilitation of the Medial- and Lateral Collateral Ligament-deficient Elbow: An In Vitro Biomechanical Study

Rehabilitation of the Medial- and Lateral Collateral Ligament-deficient Elbow: An In Vitro Biomechanical Study

The Effect of Wrist Position on Finger Tendon Loads Following Pulley Sectioning and Operative Reconstruction

Effect of Radial Neck Length on Joint Loading

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