Ramsey Matthew, Neale Patricia G, Morrey Bernard F, O'driscoll Shawn W, An Kai-Nan
Biomechanics Laboratory, Division of Orthopedic Research, Mayo Clinic/Mayo Foundation, Rochester, MN 55905, USA.
J Shoulder Elbow Surg. 2003 Jul-Aug;12(4):385-90. doi: 10.1016/s1058-2746(02)86885-9.
This study examined the kinematic characteristics of the Pritchard ERS elbow-resurfacing system, with special attention paid to the effects of the radial head component. The kinematics between the ulna and humerus were assessed in 6 human cadaveric specimens by an electromagnetic tracking system throughout a full flexion/extension range of motion. The elbows were studied under 2 loading conditions, in 3 orientations (neutral, varus, and valgus), and under 4 surgical conditions. The varus/valgus and internal/external rotation laxities were used to assess the condition differences. Specifically, the maximum laxities throughout the extension motion were compared, as were the laxities at 40 degrees, 75 degrees, and 110 degrees of flexion. Both the varus/valgus and internal/external rotation laxities of the ulnohumeral joint increased after total elbow arthroplasty (TEA) implantation, with and without a radial head. This increase was most evident in the extension portion of the arc of motion. At 40 degrees of flexion, the varus/valgus laxity of the intact elbow was 4 degrees +/- 2 degrees versus 11 degrees +/- 8 degrees for a TEA with a radial head and 22 degrees +/- 11 degrees for a TEA without a radial head while the elbow was being subjected to compressive loads via the biceps, brachialis, and triceps. The kinematic data demonstrate a consistent increase in laxity with the Pritchard ERS TEA. They also indicate that a radial head component is necessary for optimal tracking and stability of the ERS arthroplasty.
本研究考察了普里查德ERS肘关节表面置换系统的运动学特征,特别关注了桡骨头部件的影响。通过电磁跟踪系统在6具人体尸体标本的整个屈伸运动范围内评估尺骨与肱骨之间的运动学。在2种负荷条件、3种方向(中立、内翻和外翻)以及4种手术条件下对肘关节进行研究。以内翻/外翻和内旋/外旋松弛度来评估不同条件之间的差异。具体而言,比较了整个伸展运动过程中的最大松弛度以及在40度、75度和110度屈曲时的松弛度。无论有无桡骨头,全肘关节置换术(TEA)植入后尺肱关节的内翻/外翻和内旋/外旋松弛度均增加。这种增加在运动弧的伸展部分最为明显。在40度屈曲时,完整肘关节的内翻/外翻松弛度为4度±2度,而有桡骨头的TEA为11度±8度,无桡骨头的TEA为22度±11度,此时肘关节通过肱二头肌、肱肌和肱三头肌承受压缩负荷。运动学数据表明,普里查德ERS TEA的松弛度持续增加。数据还表明,桡骨头部件对于ERS人工关节置换的最佳跟踪和稳定性是必要的。