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Published on: March 12, 2021
Elbow kinematics after radiocapitellar arthroplasty
M T Sabo1, H Shannon, S De Luce
1St Joseph's Health Care, University of Western Ontario, London, Ontario, Canada.
The Journal of Hand Surgery
|April 7, 2012
Summary
Radiocapitellar arthroplasty restores normal elbow kinematics when the medial collateral ligament (MCL) is intact. However, it does not fully restore kinematics in MCL-deficient elbows, suggesting MCL reconstruction may be needed for optimal outcomes.
Area of Science:
- Orthopedic surgery
- Biomechanics
- Reconstructive surgery
Background:
- Combined radial head and capitellar deficiency presents a reconstructive challenge.
- Radiocapitellar arthroplasty is a proposed solution for these combined deficiencies.
- Assessing the kinematic impact of this arthroplasty is crucial for understanding its efficacy.
Purpose of the Study:
- To evaluate the effect of radiocapitellar replacement on elbow joint kinematics.
- To test the hypothesis that intact medial collateral ligament (MCL) allows radiocapitellar arthroplasty to replicate normal elbow kinematics.
- To compare radiocapitellar arthroplasty kinematics against a deficient lateral column and MCL conditions.
Main Methods:
- Utilized 7 cadaveric arms in an advanced upper extremity joint simulator.
- Employed computed tomography for precise implant sizing and computer-assisted insertion.
- Measured elbow kinematics using electromagnetic tracking during flexion, focusing on varus-valgus and rotational motion.
Main Results:
- Radiocapitellar arthroplasty demonstrated no kinematic difference compared to the postosteotomy control.
- MCL-deficient elbows exhibited increased valgus angulation and external ulnar rotation.
- Lateral column deficiency led to increased external ulnar rotation during active flexion.
Conclusions:
- Radiocapitellar arthroplasty effectively restores normal elbow kinematics when the MCL is intact.
- In cases of MCL deficiency, radiocapitellar arthroplasty alone does not fully restore normal kinematics.
- Consideration of radiocapitellar arthroplasty is recommended for lateral column deficiency, with potential benefit from concurrent MCL reconstruction.
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