Schelhaas, R. (Reslin) (2021) Changes in the flexion-extension axis of the elbow following total elbow arthroplasty – a pilot cadaver study. thesis, Human Movement Sciences.
Full text available on request.Abstract
Total elbow arthroplasty (TEA) is a surgical procedure in which a surgeon replaces the elbow with a prosthesis. Complication rates after TEA are high, and survival rates of elbow prostheses are low. One of the most important changes that could occur following TEA is a change in the location and orientation of the flexion-extension axis of the elbow. Failure to accurately reconstruct the flexion-extension axis affects the elbow load and increases the chance of complications. The primary goal of the current paper is, therefore, to investigate the changes in the location and orientation of the flexion-extension axis of the elbow that occur following TEA. Two series of measurements were performed on the left upper-limb of an anatomical specimen, before and after a Latitude linked TEA (Tornier, Stafford, TX, USA) using a triceps-on approach was performed. Passive flexion-extension movements were performed with the forearm in the neutral position, in pronation and in supination. Reflective markers were attached to the humerus, radius and ulna and movements were recorded with OptiTrack Flex 3 (NaturalPoint, Inc., Corvallis, OR, USA). Based on marker position data, the location and orientation of the flexion-extension axis of the elbow were determined in both the frontal and transversal planes. A Wilcoxon signed-rank test was performed to test whether there was a change in the orientation of the flexion-extension axis after TEA. The results show that, over all movement trials, there was a significant change in the orientation of the flexion-extension axis post TEA compared with pre TEA in both the frontal plane (median pre-TEA = 11°; median post-TEA = -5°; p=0.031) and the transversal plane (median pre-TEA = 12°; median post-TEA = 19° p=0.031). Examination of the prosthesis post-operatively revealed that a part of the 7 degrees varus-valgus laxity was already used in the neutral position because of an alignment error of the ulnar component. In this pilot cadaver study, a significant change is seen in the orientation of the flexion-extension axis post-TEA compared with pre-TEA in both the frontal and transversal planes. The results stress the importance of properly aligning both the humeral and ulnar components during TEA. Future studies should test the repeatability and reliability of the current method and test whether this method could be used to determine the location and orientation of the flexion-extension axis in patients following TEA. Future research should also investigate to what extent a change in the flexion-extension axis affects the accuracy of the model predicted elbow load after TEA.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Vegter, dr. R.J.K. and Murgia, dr. A.M. and Mouton, dr. L.J. and Meijering, D. |
| Faculty: | Medical Sciences |
| Date Deposited: | 13 May 2022 14:28 |
| Last Modified: | 13 May 2022 14:28 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/3315 |
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