Defining the Flexion-Extension Axis of the Ulna: Implications for Intra-Operative Elbow Alignment-Reference-Cited by-同舟云学术

Defining the Flexion-Extension Axis of the Ulna: Implications for Intra-Operative Elbow Alignment

Published:2008-12-10 Issue:2 Volume:131 Page:
ISSN:0148-0731
Container-title:Journal of Biomechanical Engineering
language:en
Short-container-title:

Author:

Brownhill James R.¹,Ferreira Louis M.¹,Pichora James E.²,Johnson James A.³,King Graham J. W.⁴

Affiliation:

1. Bioengineering Research Laboratory, The Hand and Upper Limb Center, St. Joseph’s Health Care London, 268 Grosvenor Street, London, ON, N6A 4L6, Canada; Department of Biomedical Engineering, The University of Western Ontario, London, ON, N6A 4L6, Canada

2. Bioengineering Research Laboratory, The Hand and Upper Limb Center, St. Joseph’s Health Care London, 268 Grosvenor Street, London, ON, N6A 4L6, Canada; Department of Medical Biophysics, The University of Western Ontario, London, ON, N6A 4L6, Canada

3. Bioengineering Research Laboratory, The Hand and Upper Limb Center, St. Joseph’s Health Care London, 268 Grosvenor Street, London, ON, N6A 4L6, Canada; Department of Biomedical Engineering, Department of Surgery, and Department of Medical Biophysics, The University of Western Ontario, London, ON, N6A 4L6, Canada

4. Bioengineering Research Laboratory, The Hand and Upper Limb Center, St. Joseph’s Health Care London, 268 Grosvenor Street, London, ON, N6A 4L6, Canada; Department of Surgery, and Department of Medical Biophysics, The University of Western Ontario, London, ON, N6A 4L6, Canada

Abstract

The increased utilization of total elbow replacements has resulted in a correspondingly increased number of failed implants requiring revision. The most common reason for revision is aseptic loosening of the ulnar component due to polyethylene induced osteolysis. Implant malalignment is thought to be an important cause of bearing wear and implant failure. The ulnar flexion axis can be used to accurately align the ulnar component of the elbow implant; however, the optimal method of determining this axis intra-operatively is unknown. This in vitro study determined the relationship amongst kinematically and anatomically defined ulnar flexion axes in an effort to improve the accuracy of ulnar component positioning. Five different techniques were used to determine the ulnar flexion axis in 12 cadaveric specimens, 3 kinematic and 2 anatomic. The techniques were compared with the screw displacement axis from simulated elbow flexion. An anatomic measurement technique using the guiding ridge of the greater sigmoid notch of the ulna and the radial head was found to most accurately replicate the position and orientation of the screw displacement axis of the elbow (p<0.05). Because an anatomically derived flexion axis can be determined using both pre-operative imaging techniques, as well as with intra-operative guides, it is more practical than kinematically derived techniques requiring tracking systems for clinical application and should provide reliable and consistent results.

Publisher

ASME International

Subject

Physiology (medical),Biomedical Engineering

Link

http://asmedigitalcollection.asme.org/biomechanical/article-pdf/doi/10.1115/1.3005203/5487430/021005_1.pdf

Reference19 articles.

1. Functional Outcome of Semiconstrained Total Elbow Arthroplasty;Hildebrand;J. Bone Jt. Surg., Am. Vol.

2. Primary Total Elbow Replacement for Fractures of the Distal Humerus;Müller;Oper. Orthop. Traumatol.

3. Proximal Ulnar Reconstruction With Strut Allograft in Revision Total Elbow Arthroplasty;Kamineni;J. Bone Jt. Surg., Am. Vol.

4. Revision of Unstable Capitellocondylar (Unlinked) Total Elbow Replacement;Ring;J. Bone Jt. Surg., Am. Vol.

5. Impaction Grafting in Revision Total Elbow Arthroplasty;Loebenberg;J. Bone Jt. Surg., Am. Vol.

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