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

Alolabi, Bashar; Gray, Alia; Ferreira, Louis M.; Johnson, James A.; Athwal, George S.; King, Graham J.W.

doi:10.1016/j.jht.2012.06.001

Cited by 22 publications

(9 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In addition, the pronation and supination strength training started at 3 months. This is because stress has been found to biomechanically impact ligament instability in the valgus and varus positions [ 11 ]. Physiologically, representative mechanisms of muscle strength improvement appear due to neuromuscular adaptation and hypertrophy [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

“…Considering the fact that the MCL and LCL were injured in the patients in this study, ROM exercise was delayed until the 7th day after surgery, which is still relatively early. In addition, the supination and pronation exercises were performed carefully at 3 weeks since valgus and varus stress is dangerous in patients with this complex injury [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

“…In addition, one study introduced a rehabilitation program conducted immediately after surgery [ 10 ]. However, LCL single injury or MCL and LCL complex injury is often caused by trauma, such as dislocation, and the frequency of damage and related studies are less than for MCL [ 11 , 12 ]. Although some studies have indicated that rehabilitation is possible immediately after surgery, the results of studies on cases are very rare [ 13 , 14 ].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Early Rehabilitation after Surgical Repair of Medial and Lateral Collateral Elbow Ligaments: A Report of Three Cases

Kim

Choi

Lee

2020

IJERPH

View full text Add to dashboard Cite

Elbow ligament injuries are commonly caused by overuse; degeneration; and trauma; such as from a fall or collision. The purpose of this study was to present the results of three cases involving patients undergoing early rehabilitation after surgical treatment for complex injury of the elbow medial collateral ligament (MCL) and lateral collateral ligament (LCL). Two patients were non-athlete middle-aged women and one was a recreational judo player. Surgery was performed through open incision or arthroscopically. Rehabilitation consisted of range of motion (ROM) exercise; muscle strength restoration; and neuromuscular training. Passive ROM exercise and isometric strength exercise began at 7 days; isotonic strength training at 6 weeks; and neuromuscular training at 3 months after operation. Center- and home-based methods of exercise participation were combined. Center-based exercises were performed 1–2 times per week for the first 6 months and 1–2 times per month for the next 6 months. Patients also performed home-based and self-monitoring exercise. Examinations included ROM using a goniometer; muscle strength test using isokinetic equipment; and Oxford elbow score. In the six months after surgery; flexion ROM was 130° for Case A (health side 145°), 110° for Case B (health side 145°), and 135° for Case C (health side 135°); grip strength was restored to 13 kg (health side 28 kg), 16 kg (health side 25 kg), and 38 kg (health side 52 kg); and isokinetic flexion strength was improved to 30 Nm (health side 58 Nm), 21 Nm (health side 50 Nm), and 72 Nm (health side 80 Nm), respectively. In conclusion; patients who underwent early rehabilitation recovered ROM and muscle strength and returned to daily activity without any side effects. This study showed that patients with elbow MCL and LCL injuries took approximately 3 months to recover meaningful ROM; approximately 6 months to recover muscle strength; and 4–8 months to play light recreational sports. In addition; it took patients 6 weeks to return to their daily activities and 6 months to improve questionnaire scores in their function and pain during daily activity. In follow-up two years after surgery; all three patients had full ROM and muscle strength within 10% of the healthy side

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Early Rehabilitation after Surgical Repair of Medial and Lateral Collateral Elbow Ligaments: A Report of Three Cases

Kim

Choi

Lee

2020

IJERPH

View full text Add to dashboard Cite

show abstract

“…Elbow dislocations are very common in adults and children and represent 11–28% of all elbow injuries at an average annual rate of 6 to 13 cases per 100,000 population [1,2]. Dislocations of the elbow can be simple, where the dislocation occurs with the medial collateral ligament (MCL) and/or lateral collateral ligament injury or can be complex, where the dislocation causes both ligament injury and fracture of the articular surface [2].…”

Section: Introductionmentioning

confidence: 99%

Medial Collateral Ligament Deficiency of the Elbow Joint: A Computational Approach

2018

View full text Add to dashboard Cite

Computational elbow joint models, capable of simulating medial collateral ligament deficiency, can be extremely valuable tools for surgical planning and refinement of therapeutic strategies. The objective of this study was to investigate the effects of varying levels of medial collateral ligament deficiency on elbow joint stability using subject-specific computational models. Two elbow joint models were placed at the pronated forearm position and passively flexed by applying a vertical downward motion on humeral head. The models included three-dimensional bone geometries, multiple ligament bundles wrapped around the joint, and the discretized cartilage representation. Four different ligament conditions were simulated: All intact ligaments, isolated medial collateral ligament (MCL) anterior bundle deficiency, isolated MCL posterior bundle deficiency, and complete MCL deficiency. Minimal kinematic differences were observed for isolated anterior and posterior bundle deficient elbows. However, sectioning the entire MCL resulted in significant kinematic differences and induced substantial elbow instability. Joint contact areas were nearly similar for the intact and isolated posterior bundle deficiency. Minor differences were observed for the isolated anterior bundle deficiency, and major differences were observed for the entire MCL deficiency. Complete elbow dislocations were not observed for any ligament deficiency level. As expected, during isolated anterior bundle deficiency, the remaining posterior bundle experiences higher load and vice versa. Overall, the results indicate that either MCL anterior or posterior bundle can provide anterior elbow stability, but the anterior bundle has a somewhat bigger influence on joint kinematics and contact characteristics than posterior one. A study with a larger sample size could help to strengthen the conclusion and statistical significant.

show abstract

“…The periarticular muscle groups are dynamic contributors that promote an increase in constrictive force. 2 , 3 …”

Section: Introductionmentioning

confidence: 99%

Analysis of the Pattern and Mechanism of Elbow Injuries Related to Armbar-Type Armlocks in Jiu-Jitsu Fighters

et al. 2017

View full text Add to dashboard Cite

Objective:The objective of this study was to analyze elbow injuries and their probable mechanism in Jiu-Jitsu fighters resulting from the armbar-type armlock. Methods:We evaluated 5 high-performance Jiu-Jitsu fighters from the Gracie Elite gym who were injured during a tournament. All were healthy males with a mean age of 28.8 years. The right arm was involved in three patients (60%). The athletes were followed for approximately 4.6 months, and pain was present in all cases. Clinical examination of the elbow was performed immediately after the injury and when magnetic resonance imaging (MRI) was performed. The radiography showed no changes. Clinical examination detected specific tender points on the medial and anterior topography of the elbows, but no ligamentous instability of the elbow was seen during dynamic testing. Results:The main MRI findings were injury to the common flexor tendon and the ulnar collateral ligament, bone contusion of the distal humerus and olecranon, and joint effusion. Conclusion:The main pattern of injury indicated by the MRI in the athletes was injury to the medial elbow complex. The primary mechanism that determined the injury was most likely elbow hyperextension applied with the forearm in neutral position of forearm. Level of Evidence IV, Case Series.

show abstract

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

Cited by 22 publications

References 27 publications

Early Rehabilitation after Surgical Repair of Medial and Lateral Collateral Elbow Ligaments: A Report of Three Cases

Early Rehabilitation after Surgical Repair of Medial and Lateral Collateral Elbow Ligaments: A Report of Three Cases

Medial Collateral Ligament Deficiency of the Elbow Joint: A Computational Approach

Analysis of the Pattern and Mechanism of Elbow Injuries Related to Armbar-Type Armlocks in Jiu-Jitsu Fighters

Contact Info

Product

Resources

About