Background: Radial head excision (RHE) has been shown to increase contact pressures within the ulnohumeral joint. Radiocapitellar interposition arthroplasty (RCIA) with the use of a soft tissue graft is an alternative for the treatment of isolated radiocapitellar arthritis or with failure of radial head replacement. We investigated contact pressures and contact area within the ulnohumeral joint after RHE compared to RCIA with dermal autograft.
Methods: Six fresh-frozen cadaver elbows were tested on a custom dynamic elbow frame. A pressure sensor was inserted into the intact elbow joint, and mean contact pressure, peak contact pressure, contact area, and force within the ulnohumeral joint were recorded at 0°, 30°, 60°, 90°, and 120° of flexion as a valgus load was applied to the elbow. The radial head was then excised and specimens were retested. Finally, a dermal graft matched to the size of the resected radial head was inserted in the radiocapitellar space and the specimens were tested a third time.
Results: At 90° of flexion, contact pressure within the ulnohumeral joint was significantly lower with RCIA compared with RHE (110.8 kPa vs 216.8 kPa; P = .013). The mean peak contact pressure was also significantly lower with RCIA compared with RHE at 90° (279.4 vs 626.7 kPa; P = .025). No statistically significant differences were seen in mean contact area or force between the 3 testing conditions at any flexion position.
Conclusion: RCIA with a dermal graft reduced contact pressures within the ulnohumeral joint compared to RHE at 90° of flexion without a significant change in contact area or contact force.
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http://dx.doi.org/10.1016/j.jse.2022.09.008 | DOI Listing |
Clin Orthop Relat Res
December 2024
Department of Orthopaedic Surgery, University Medical Centre Groningen and Groningen University, Groningen, the Netherlands.
ANZ J Surg
November 2024
Department of Biomedical Engineering, Keele University, Keele, ST5 5BG, Staffordshire, UK.
Background: The authors present a cadaveric validation of a minimally invasive articular cartilage preserving olecranon osteotomy technique for use in the operative management of distal humeral fractures.
Methods: Twenty-four elbows in six male and six female formaldehyde embalmed cadavers were dissected. With the cadaver placed in a lateral decubitus position, a posterior sub-periosteal dissection was performed to the medial and lateral aspects of the olecranon at the level of the joint and Mini Hohmann retractors were inserted into each side of the ulnohumeral joint.
Shoulder Elbow
November 2024
University of Pittsburgh Medical Center, Department of Orthopaedic Surgery, Pittsburgh, USA.
Objective: The purpose of this study was to evaluate the sensitivity of three arthroscopic techniques for intraoperative assessment of posterolateral rotatory instability (PLRI).
Methods: The study was performed using six fresh frozen cadaveric upper extremities. The three arthroscopic tests were the modified ulnohumeral drive through test, the annular drive through test, and proximal radioulnar joint instrumentation.
Sci Rep
November 2024
Department of Sports Medical Science, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan.
Evaluating complicated stress across the elbow under joint motion remains difficult. Here, we aimed to evaluate the distribution of the subchondral bone density in the normal elbow bones and further characterize their spatial relationships during elbow motion to estimate the loading stress across the articular surface using three-dimensional computed tomography bone models. The normal elbow joint exhibited a consistent distribution pattern of subchondral bone density.
View Article and Find Full Text PDFDiagnostics (Basel)
September 2024
Department of Orthopaedic Surgery, Tokyo Medical University Ibaraki Medical Center, Ami 300-0395, Ibaraki, Japan.
Background/objectives: We previously reported that traction magnetic resonance imaging (MRI) of the elbow without arthrography increases the width of the radiocapitellar joint (RC) and improves articular cartilage visibility. However, the effects of axial traction on different age groups have not yet been evaluated. We hypothesized that the effect of traction would decrease as the participants' age increased.
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