Chen Jeffrey S, Beckwitt Colin H, Robertson Emerald D, Bosetti Alexandria A, Baratz Mark E, Kaufmann Robert A
Department of Orthopedic Surgery, University of Pittsburgh Medical Center, PA, USA.
Hand (N Y). 2024 Oct 24:15589447241284669. doi: 10.1177/15589447241284669.
Outcomes of interposition arthroplasty for treatment of elbow arthritis are highly dependent on elbow stability. The purpose of this study was to determine whether interposition arthroplasty with a novel bidirectional ligament reconstruction technique could adequately restore the static stability of the native elbow.
Static varus and valgus elbow stability was tested in 7 cadaver elbows with intact ligaments and capsule at 5 flexion angles (0°, 30°, 60°, 90°, and 120°). At each angle, the distance between fixed reference points across the elbow was measured both medially and laterally. The elbows were then destabilized and an interposition arthroplasty with ligament reconstruction was performed. Static elbow stability was reassessed by comparing postoperative deflection measurements with those of the native state. Graft slippage or loosening was visually assessed following testing.
Interposition arthroplasty was performed in 7 cadaver specimens. Following ligament reconstruction, specimens reproduced the flexion angle-dependent static stability of native elbows to both varus and valgus stress. The greatest deflection changes between native elbows and elbows after interposition arthroplasty were 2.7% ( = .13) medially and 2.3% ( = .42) laterally, which were not significant. There was no loosening or slippage of either the interposition graft or the ligament reconstruction grafts.
Cadaveric elbow specimens underwent interposition arthroplasty with a novel technique for bidirectional ligament reconstruction. Static stability was maintained at varying degrees of elbow flexion, comparable to that of the native elbow. Interposition and ligament reconstruction grafts maintained secure fixation following static biomechanical testing.
间置关节成形术治疗肘关节关节炎的疗效高度依赖于肘关节的稳定性。本研究的目的是确定采用新型双向韧带重建技术的间置关节成形术能否充分恢复天然肘关节的静态稳定性。
对7具韧带和关节囊完整的尸体肘关节在5个屈曲角度（0°、30°、60°、90°和120°）下进行静态内翻和外翻稳定性测试。在每个角度，测量肘关节内外侧固定参考点之间的距离。然后使肘关节失稳，并进行带韧带重建的间置关节成形术。通过比较术后与天然状态下的位移测量值来重新评估肘关节的静态稳定性。测试后通过肉眼评估移植物的滑动或松动情况。
对7个尸体标本进行了间置关节成形术。韧带重建后，标本在内外翻应力下重现了天然肘关节依赖于屈曲角度的静态稳定性。天然肘关节与间置关节成形术后肘关节之间最大的位移变化在内侧为2.7%（P = 0.13），在外侧为2.3%（P = 0.42），差异均无统计学意义。间置移植物或韧带重建移植物均未出现松动或滑动。
尸体肘关节标本采用新型双向韧带重建技术进行了间置关节成形术。在不同程度的肘关节屈曲时均维持了静态稳定性，与天然肘关节相当。在静态生物力学测试后，间置移植物和韧带重建移植物保持了牢固的固定。
