Abstract:
:The contribution of the medial and lateral collateral ligaments (MCL, LCL) and muscle forces to the kinematics and stability of the capitellocondylar total elbow arthroplasty was investigated in six fresh cadaveric elbows. The three-dimensional orientation of the ulna relative to the humerus was monitored with the use of an electromagnetic tracking device in neutral, valgus, and varus stress positions with (1) the ligaments intact, (2) LCL insufficiency obtained by osteotomizing the lateral epicondyle, (3) partial MCL insufficiency obtained by sectioning either the anterior or posterior bundle of the MCL, and (4) complete MCL insufficiency. Simulated muscle forces were applied as follows: (1) no load, (2) 1 kg each to the biceps and the brachialis and 2 kg to the triceps, and (3) 2 kg to the biceps and the brachialis and 4 kg to the triceps. The laxity was defined as the difference in valgus/varus orientation of the ulna in the valgus and varus stress positions. The laxity at 40°, 75°, and 110° elbow flexion was analyzed. The greatest laxity occurred with LCL insufficiency (40.7° ± 11.6°, average at three flexion angles) followed by that with MCL insufficiency (15.7° ± 9.9°), both of which were significantly larger than laxity with the intact ligaments (5.6° ± 2.5°). The laxity with the anterior bundle sectioned (12.0° ± 8.1°) was significantly greater than with the posterior bundle sectioned (3.3° ± 3.6°); thus the contribution of anterior bundle to stability was four times that of posterior bundle. Stabilizing effect of muscle loading was small in elbows with intact ligaments, whereas it was large with LCL or MCL insufficiency. Based on these data, we can see that the integrity of both the MCL and LCL is essential to maintain stability of this total elbow, the anterior bundle is a more important stabilizer than the posterior bundle, and the collateral ligaments seem to be the primary stabilizer and the musculature seems to be the secondary stabilizer. Careful implantation technique to preserve the collateral ligaments is required to obtain postoperative stability of this arthroplasty. Otherwise, routine exposure of the MCL and repair or reinforcement of the MCL, if deficient, may need to be considered during surgery.
journal_name
J Shoulder Elbow Surgjournal_title
Journal of shoulder and elbow surgeryauthors
Itoi E,King GJ,Morrey BF,An KNdoi
10.1016/S1058-2746(09)80069-4subject
Has Abstractpub_date
1992-09-01 00:00:00pages
271-9issue
5eissn
1058-2746issn
1532-6500pii
S1058-2746(09)80069-4journal_volume
1pub_type
杂志文章abstract:BACKGROUND:Although massive rotator cuff tears occasionally lead to severe impairment of shoulder function, the criteria for losing the ability to elevate the arm are unclear. This study aimed to analyze the features of both tear size and 3-dimensional (3D) shoulder kinematics that correspond to the loss of the ability...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2020.07.021
更新日期:2020-08-01 00:00:00
abstract:BACKGROUND:Anterior shoulder dislocation in the young patient is a common problem, yet there is no universal agreement on its management. METHODS:In this study, we comprehensively surveyed all members of the British Elbow and Shoulder Society (BESS) to ascertain their preferred methods of treating young patients with ...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2011.01.006
更新日期:2012-04-01 00:00:00
abstract:BACKGROUND:Despite an increasing prevalence of patients sustaining pathologic fractures of neoplastic origin, few studies have investigated 30-day postoperative complication profiles following surgical treatment of pathologic humerus fractures. The purposes of this study were to use a large nationally representative da...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2020.10.024
更新日期:2020-11-18 00:00:00
abstract:BACKGROUND:Baseplate loosening in reverse total shoulder arthroplasty (RTSA) remains a concern. Placing peripheral screws into the 3 pillars of the densest scapular bone is believed to optimize baseplate fixation. Using a 3-dimensional computer-aided design (3D CAD) program, we investigated the optimal rotational basep...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2015.01.012
更新日期:2015-09-01 00:00:00
abstract:BACKGROUND:Many studies that describe factors affecting outcome in primary rotator cuff repair (RCR) have been published, but so far there is no review that summarizes them. This systematic review was conducted to identify prognostic factors influencing functional (clinical) outcome and radiologically proven cuff integ...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jse.2014.01.001
更新日期:2014-07-01 00:00:00
abstract:BACKGROUND:The Oxford Shoulder Score (OSS) is an internationally-used patient-based outcome score. Up to now, it was not validated in Dutch. The purpose of this study was to produce a Dutch translation of the OSS and to test this version in terms of reliability and validity. METHODS:Translation of the OSS was done acc...
journal_title:Journal of shoulder and elbow surgery
pub_type: 临床试验,杂志文章
doi:10.1016/j.jse.2010.01.017
更新日期:2010-09-01 00:00:00
abstract:BACKGROUND:The pennation angle is an important architectural and functional feature of pennate muscles. The purpose of this study was to investigate the change in the pennation angle of the supraspinatus muscle after rotator cuff tear repair. MATERIALS AND METHODS:The study included 68 patients who underwent arthrosco...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2018.10.021
更新日期:2019-05-01 00:00:00
abstract:BACKGROUND:A novel arthroscopic technique allows for intraosseous tendon placement in biceps tenodesis using bone tunnels and suture while avoiding the expense of an implant. No biomechanical characterization exists for this construct. METHODS:Tensile tests were used to compare a suture-only biceps tenodesis technique...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2014.02.027
更新日期:2014-11-01 00:00:00
abstract:BACKGROUND:The purpose of this study was 2-fold: (1) to quantify type E2 bone loss orientation and its association with rotator cuff fatty infiltration and (2) to examine reverse baseplate designs used to manage type E2 glenoids. METHODS:Computed tomography scans of 40 patients with type E2 glenoids were examined for ...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2019.11.009
更新日期:2020-07-01 00:00:00
abstract::Radiographic bone loss and clinical outcome were evaluated at a median of 6 years after interposition arthroplasty was performed in 35 elbows with rheumatoid arthritis. Seven early postoperative complications, two major and five minor, occurred. Three elbows subsequently required total elbow replacement. Clinical resu...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/s1058-2746(96)80001-2
更新日期:1996-03-01 00:00:00
abstract:BACKGROUND:Distal biceps tendon repair to the radial tuberosity can be conducted by means of an interference screw in combination with a transosseous button. Bioabsorbable interference screws have been associated with complications such as severe osteolytic reactions. We questioned whether patients with a distal biceps...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2015.12.007
更新日期:2016-03-01 00:00:00
abstract:HYPOTHESIS:The aim of this study was to assess the effect of open resection arthroplasty for osteoarthritis of the sternoclavicular (SC) joint on pain levels, functional outcomes, and return to sport. METHODS:Patients from a single surgeon's practice who underwent open resection arthroplasty (maximum 10-mm resection) ...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2016.07.008
更新日期:2017-02-01 00:00:00
abstract:BACKGROUND:The precise surgical anatomy of the lower trapezius tendon transfer has not been well described. A precise anatomic description of the different trapezius segments and the associated neurovascular structures is crucial for operative planning and execution. We aimed (1) to establish a reliable demarcation bet...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2014.12.033
更新日期:2015-09-01 00:00:00
abstract:BACKGROUND:We performed a meta-analysis of studies with at least Level IV evidence to compare outcomes between hemiarthroplasty and reverse shoulder arthroplasty for the treatment of proximal humeral fractures. METHODS:Three electronic databases (PubMed, Cochrane, and EMBASE) were searched. The quality of each study w...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.jse.2015.08.030
更新日期:2016-02-01 00:00:00
abstract:HYPOTHESIS:Traumatic injuries to the ulnar nerve at the elbow are a frequent problem as it is vulnerable to stretching and compression with motion of the upper limb. The aim of the present study was to explore the course of the ulnar nerve at the elbow and forearm and to determine possible anatomical structures that ma...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2009.03.004
更新日期:2009-07-01 00:00:00
abstract::One hundred consecutive stiff shoulders in 93 patients resistant to conservative therapy were treated with surgery and intermittent regional anesthesia via indwelling interscalene catheter. Each patient underwent manipulation and one of several operative treatments to release any additional contracture. The indwelling...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1067/mse.2000.106083
更新日期:2000-07-01 00:00:00
abstract:HYPOTHESIS:A review of the current literature will show a difference between the biomechanical properties of double-row and single-row rotator cuff repairs. BACKGROUND:Rotator cuff tears commonly necessitate surgical repair; however, the optimal technique for repair continues to be investigated. Recently, double-row r...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jse.2009.07.002
更新日期:2009-11-01 00:00:00
abstract:BACKGROUND:Large glenoid bone defects in the setting of glenohumeral arthritis can present a challenge to the shoulder arthroplasty surgeon. The results of large structural autografting at the time of reverse total shoulder arthroplasty (RTSA) are relatively unknown. METHODS:This retrospective case series describes th...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2017.07.010
更新日期:2018-01-01 00:00:00
abstract::The incorrect determination of the flexion-extension axis of the elbow may result in poor clinical outcomes for patients undergoing ligament repairs, joint arthroplasties, and procedures requiring articulated external fixators. The variability in the selection of the flexion-extension axis based on a visual approximat...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2005.09.011
更新日期:2006-07-01 00:00:00
abstract::An anatomic structure frequently observed during glenohumeral joint arthroscopy is described as the vincula of the long head of the biceps brachia tendon. These vincula were present in 24.3% of 411 shoulders (390 patients) undergoing shoulder arthroscopy. There was single vinculum in 56 shoulders, two vincula in 32, t...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/1058-2746(92)90095-K
更新日期:1992-05-01 00:00:00
abstract:BACKGROUND:Instability arthropathy is a known cause of glenohumeral osteoarthritis (OA) among patients with and without prior shoulder stabilization. This study aims to compare the clinical, radiographic, and patient-reported outcome measure (PROM) scores among total shoulder arthroplasty (TSA) patients with and withou...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2020.04.003
更新日期:2020-07-01 00:00:00
abstract:BACKGROUND:Pitching causes increased mechanical stress to the arm and is thought to result in alterations in range of motion (ROM) as a result of osseous and soft tissue adaptations. Understanding the factors that contribute to alterations in ROM will allow for improved understanding of the pitching shoulder. This stud...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2011.11.035
更新日期:2012-11-01 00:00:00
abstract::Animal models designed to investigate the biologic aspects of rotator cuff pathology are being used and being developed in the rat, rabbit, dog, and other mammals. The current models have provided valuable information regarding the etiology, pathogenesis, and healing potential of the tendon, as well as effective surgi...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2007.05.002
更新日期:2007-09-01 00:00:00
abstract::The incidence of primary and secondary bicipital tendinitis remains unknown. In our prospective study, 200 consecutive shoulders underwent arthroscopic subacromial decompression for impingement syndrome. A biceps tenodesis was performed in 80 shoulders (40%) featuring macroscopic degeneration of the long head of the b...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1067/mse.2000.108386
更新日期:2000-09-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to determine the results, complications, and failure rates of shoulder arthroplasty in morbidly obese patients. METHODS:Between 1994 and 2005, 45 shoulder arthroplasties were performed for osteoarthritis in patients with a BMI greater than 40. Forty-one shoulders were followed ...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2009.02.006
更新日期:2009-11-01 00:00:00
abstract:BACKGROUND:Defining a simple and reliable classification for acromial and bursal impingement lesions is necessary to standardize terminology, to improve communication, and to allow better evaluation of the proper treatment of impingement lesions and rotator cuff tears. The purpose of this study was to assess orthopedic...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2017.07.018
更新日期:2017-12-01 00:00:00
abstract:BACKGROUND:The aim of this study was to assess the influence of 3-dimensional (3D) preoperative planning and patient-specific instrument (PSI) guidance of glenoid component positioning on its inclination in total shoulder arthroplasty (TSA) and reverse shoulder arthroplasty (RSA). MATERIALS AND METHODS:Thirty-six shou...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2015.07.024
更新日期:2016-02-01 00:00:00
abstract:BACKGROUND:This study investigated the histopathology of the long head of biceps (LHB) tendon and correlated the findings with the macroscopic appearances of the LHB and the size of rotator cuff tears (RCTs) in patients with chronic RCTs. METHODS:We compared biopsy specimens from LHBs in 34 patients with chronic RCTs ...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2013.11.013
更新日期:2014-08-01 00:00:00
abstract:BACKGROUND:This study aimed to determine the extent to which the medial collateral ligament (MCL) can be visualized during a standard posterior arthroscopic view of the elbow. METHODS:Eight fresh human cadaveric elbows were placed in a simulated lateral decubitus position. Standard elbow arthroscopy was performed on e...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2019.04.040
更新日期:2019-11-01 00:00:00
abstract:INTRODUCTION:Structural glenoid bone grafting in reverse total shoulder arthroplasty (RSA) has previously been reported to have good functional outcomes and low complication rates. We have observed different complication rates and hypothesized that baseplate fixation and severity of deformity may be predictors of early...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2019.07.035
更新日期:2020-03-01 00:00:00