Elbow kinematics with increased lengthening of a radial head arthroplasty evaluated with dynamic radiostereometric analysis.
Journal
The bone & joint journal
ISSN: 2049-4408
Titre abrégé: Bone Joint J
Pays: England
ID NLM: 101599229
Informations de publication
Date de publication:
01 Oct 2024
01 Oct 2024
Historique:
medline:
1
10
2024
pubmed:
1
10
2024
entrez:
30
9
2024
Statut:
epublish
Résumé
The aim of this study was to evaluate the kinematics of the elbow following increasing length of the radius with implantation of radial head arthroplasties (RHAs) using dynamic radiostereometry (dRSA). Eight human donor arms were examined by dRSA during motor-controlled flexion and extension of the elbow with the forearm in an unloaded neutral position, and in pronation and supination with and without a 10 N valgus or varus load, respectively. The elbows were examined before and after RHA with stem lengths of anatomical size, + 2 mm, and + 4 mm. The ligaments were maintained intact by using a step-cut lateral humeral epicondylar osteotomy, allowing the RHAs to be repeatedly exchanged. Bone models were obtained from CT scans, and specialized software was used to match these models with the dRSA recordings. The flexion kinematics of the elbow were described using anatomical coordinate systems to define translations and rotations with six degrees of freedom. The greatest kinematic changes in the elbows were seen with the longest, + 4 mm, implant, which imposed a mean joint distraction of 2.8 mm in the radiohumeral joint and of 1.1 mm in the ulnohumeral joint, an increased mean varus angle of up to 2.4° for both the radius and the ulna, a mean shift of the radius of 2.0 mm in the ulnar direction, and a mean shift of the ulna of 1.0 mm posteriorly. The kinematics of the elbow deviated increasingly from those of the native joint with a 2 mm to a 4 mm lengthening of the radius. This confirms the importance of restoring the natural length of the radius when undertaking RHA.
Identifiants
pubmed: 39348898
doi: 10.1302/0301-620X.106B10.BJJ-2024-0405.R1
pii: BJJ-2024-0405.R1
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1165-1175Subventions
Organisme : P. Carl Petersens Fund
Organisme : Fonden til Lægevidenskabens Fremme
Organisme : Ortopædkirurgisk Forskningsfond
Organisme : Familien Hede Nielsens Fond
Informations de copyright
© 2024 The British Editorial Society of Bone & Joint Surgery.
Déclaration de conflit d'intérêts
J. Frost Teilmann and T. M. Thillemann report material support from Acumed, which provided the implants (radial head arthroplasties) for the study but had no influence on the conduction of the study or the interpretation of the results/publication. J. Frost Teilmann also reports funding from Ortopædkirurgisk Forskningsfond, related to this study, and a research grant from the P. Carl Petersens Fund, unrelated to this study. T. M. Thillemann reports funding from the A. P. Møller Fund (Fonden til lægevidenskabens fremme) and the Familien Hede Nielsen Fund, related to this study. M. Stilling reports a grant from the P. Carl Petersens Fund, unrelated to this study.
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