Development of a Diagnostic Tool for Elbow Instability Combining 4D-CT Imaging and Mechanical Load Analysis

Diagnosis of elbow instability in clinical practice commonly relies on manual stress testing by the physician with or without combination of fluoroscopy or ultrasound, which may result in variable force application and subjective interpretation. A standardized method for applying controlled mechanical loading during dynamic imaging may improve reproducibility.

The objective of this study was to develop and perform initial cadaveric feasibility testing of a CT-compatible diagnostic device for device-guided assessment of elbow instability with simultaneous force and positional measurement.

Technical development study with initial cadaveric feasibility testing.

Building upon the initial prototype the present paper, describes the development of MELBO the follow-up prototype with adjusted kinematics and improved stability, the validation of the force sensor is addressed, and the first cadaver test results are presented.

The MELBO diagnostic tool enabled a controlled device-guided elbow motion during 4D-CT acquisition and allowed simultaneous recording of force and positional data. The acquired dynamic CT datasets were suitable for qualitative assessment of elbow joint stability. No relevant device-related imaging artifacts were observed.

The present study demonstrates the technical feasibility of device-guided simultaneous force and positional measurement during 4D-CT using the MELBO diagnostic tool. These findings provide the basis for further cadaveric studies and future clinical investigations aimed at quantitative assessment of elbow instability under standardized loading conditions.