Hackl Michael, Wegmann Kilian, Ries Christian, Lappen Sebastian, Scaal Martin, Müller Lars Peter
Center for Orthopedic and Trauma Surgery, University Medical Center of Cologne, Kerpener Straße 62, 50937, Cologne, Germany.
Cologne Center for Musculoskeletal Biomechanics, University of Cologne, Cologne, Germany.
Surg Radiol Anat. 2017 Jun;39(6):585-591. doi: 10.1007/s00276-016-1774-y. Epub 2016 Nov 7.
The purpose of this study was to perform biomechanical testing of annular ligament (AL) reconstruction using the superficial head of the brachialis tendon (SHBT) as a distally based tendon graft. We hypothesized that posterior translation of the radial head following AL reconstruction with an SHBT graft does not significantly differ from intact specimens.
Six fresh-frozen elbow specimens were used. The stability of the radial head against posterior translation forces (30 N) was evaluated in 0°, 45°, 90° and 120° of elbow flexion. Posterior translation was obtained for the intact AL, the sectioned AL and the reconstructed AL. Cyclic loading (100 cycles) in 90° of elbow flexion was performed for the intact and the reconstructed AL.
Posterior translation of the radial head decreased during elbow flexion in native specimens. Sectioning of the AL significantly increased instability over the full range of motion. AL reconstruction with the SHBT restored the stability of the proximal radius but-other than the native AL-was not influenced by elbow flexion. In 120° of flexion the native AL provided significantly more stability when compared to the reconstructed AL. Cyclic loading did not provide significant differences between native and reconstructed specimens.
We provide a feasible technique for AL reconstruction using the SHBT. The biomechanical results obtained in this study confirm the efficacy of the procedure. AL reconstruction restores the stability of the proximal radius, yet it cannot fully mimic the complex features of the intact AL.
本研究旨在使用肱肌肌腱浅头（SHBT）作为远端带蒂肌腱移植物对环状韧带（AL）重建进行生物力学测试。我们假设，用SHBT移植物重建AL后桡骨头的后向平移与完整标本相比无显著差异。
使用六个新鲜冷冻的肘部标本。在肘关节屈曲0°、45°、90°和120°时，评估桡骨头抵抗后向平移力（30 N）的稳定性。分别获取完整AL、切断的AL和重建AL的后向平移数据。对完整和重建的AL在肘关节屈曲90°时进行循环加载（100次循环）。
在天然标本中，桡骨头的后向平移在肘关节屈曲过程中减少。切断AL在整个运动范围内显著增加了不稳定性。用SHBT重建AL恢复了桡骨近端的稳定性，但与天然AL不同，其不受肘关节屈曲的影响。在屈曲120°时，与重建的AL相比，天然AL提供了显著更高的稳定性。循环加载在天然和重建标本之间未产生显著差异。
我们提供了一种使用SHBT进行AL重建的可行技术。本研究获得的生物力学结果证实了该手术的有效性。AL重建恢复了桡骨近端的稳定性，但不能完全模拟完整AL的复杂特征。
