Alteration of Stress Distribution Patterns in Symptomatic Valgus Instability of the Elbow in Baseball Players

Funakoshi, Tadanao; Furushima, Kaoru; Momma, Daisuke; Endo, Kaori; Abe, Yuichiro; Itoh, Yoshiyasu; Fujisaki, Kazuhiro; Tadano, Shigeru; Iwasaki, Norimasa

doi:10.1177/0363546515624916

Cited by 25 publications

(38 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The high-density area (HDA) was defined as the upper one-third of the entire range, from the minimum to the maximum HU, in each individual ankle. 7 The proximal ankle joint surface was divided into 5 parts as follows: anterolateral part of the tibia (AL-Ti), anteromedial part of the tibia (AM-Ti), posterolateral part of the tibia (PL-Ti), posteromedial part of the tibia (PM-Ti), and the fibula. The distal ankle joint surface was divided into the following 4 parts: anterolateral part of the talus (AL-Ta), anteromedial part of the talus (AM-Ta), posterolateral part of the talus (PL-Ta), and posteromedial part of the talus (PM-Ta) ( Figure 1A).…”

Section: Quantitative Analysis Of the Mapping Imagesmentioning

confidence: 99%

Long-term Stress Distribution Patterns Across the Ankle Joint in Soccer Players: A Computed Tomography Osteoabsorptiometry Study

Shiota

Momma

Yamaguchi³

et al. 2020

Orthopaedic Journal of Sports Medicine

Self Cite

View full text Add to dashboard Cite

Background: The distribution pattern of subchondral bone density is considered to accurately reflect the stress distribution over a joint under long-term physiologic loading. The biomechanical characteristics of the surface of the ankle joint in soccer players can be determined by measuring this distribution pattern under long-term loading. Purpose: To evaluate the distribution of subchondral bone density across the ankle joint in soccer players and to determine the effects of soccer activities, including kicking motion, on the ankle joint surface under long-term loading conditions by computed tomography (CT) osteoabsorptiometry (CTOAM). Study Design: Cross-sectional study; Level of evidence, 3. Methods: CT imaging data were obtained from both ankles of 10 soccer players (soccer group) and 10 nonathletic volunteers (control group). The distribution patterns of subchondral bone density across the articular surface of the ankle joints were assessed by CTOAM. Quantitative analysis was performed of the locations and percentages of high-density areas on the articular surface. Results: Stress distribution patterns over the ankle joint differed between the soccer players and controls. In the soccer players, the high-density areas were found in the anterior part of the distal tibia and proximal talus as well as the distal fibula. The percentages of high-density areas were greater in the soccer players compared with controls ( P < .0001). Conclusion: Stress distribution over the articular surface of the ankle joint was affected by soccer activities. A high stress concentration was seen in soccer players in the anterior part of the tibia and talus and in the fibula; such excessive stress may lead to anterior impingement.

show abstract

Section: Quantitative Analysis Of the Mapping Imagesmentioning

confidence: 99%

Long-term Stress Distribution Patterns Across the Ankle Joint in Soccer Players: A Computed Tomography Osteoabsorptiometry Study

Shiota

Momma

Yamaguchi³

et al. 2020

Orthopaedic Journal of Sports Medicine

Self Cite

View full text Add to dashboard Cite

show abstract

“…According to the results of a previous study, the intraobserver and interobserver variations during CTOAM analysis were considered acceptable. 8…”

Section: Intraobserver Reliability and Interobserver Reproducibilitymentioning

confidence: 99%

Stress Distribution Patterns Across the Shoulder Joint in Gymnasts: A Computed Tomography Osteoabsorptiometry Study

Momma

Iwamoto

Endo

et al. 2020

Orthopaedic Journal of Sports Medicine

Self Cite

View full text Add to dashboard Cite

Background: The distribution pattern of subchondral bone density is an indicator of stress distribution over a joint surface under long-term physiologic loading. The biomechanical characteristics of the articular surfaces of the shoulder joint in gymnasts can be determined by measuring this distribution pattern. Purpose: To evaluate the distribution of subchondral bone density across the shoulder joint in male collegiate gymnasts and to determine the effects of gymnastic activities on its articular surfaces under long-term loading conditions using computed tomography osteoabsorptiometry (CTOAM). Study Design: Descriptive laboratory study. Methods: CT image data were obtained from both shoulders of 12 asymptomatic male collegiate gymnasts (gymnast group; mean age, 19.4 years; range, 18-22 years) and 10 male collegiate volunteers (control group; mean age, 20.2 years; range, 18-22 years). The distribution pattern of subchondral bone density across the articular surfaces of each shoulder joint was assessed by CTOAM. Quantitative analysis was performed of the locations and percentages of high-density areas on the articular surface. Results: Stress distribution patterns over the articular surfaces differed between the gymnasts and the controls. In the gymnasts, high-density areas were detected on the posterosuperior articular surface of the humeral head and the anterosuperior and/or posterosuperior articular surface of the glenoid. Mean bone density was greater in the gymnasts than in the controls ( P < .0001). Conclusion: Stress distribution over the articular surfaces of the shoulder joint was affected by gymnastic activities. Stress was concentrated over the superior part of the glenohumeral joint in male collegiate gymnasts. Clinical Relevance: The present findings suggest that gymnastic activities increase stress to the articular surfaces of the superior glenohumeral joint. This supports the notion that mechanical conditions play a crucial role in the origin of disorders particular to gymnastic activities.

show abstract

“…Several studies reported excessive valgus stress on the elbow joint in pitching activity. 6,7,17 An important biomechanical study in pitching activity demonstrated that compressive forces measuring 500 N were observed in the radiocapitellar joint during the late cocking and early acceleration phases of throwing. 6 This excessive valgus stress may also reflect radial head enlargement and the skeletal age difference between the radial heads.…”

Section: Discussionmentioning

confidence: 99%

Predictors of Unsuccessful Nonoperative Management of Capitellar Osteochondritis Dissecans

et al. 2019

Self Cite

View full text Add to dashboard Cite

Background: Osteochondritis dissecans of the humeral capitellum (capitellar OCD) is a common injury among adolescent throwing athletes. Some younger patients with incomplete maturity of the epiphysis and early-stage capitellar OCD are good candidates for nonoperative treatment. However, during initial examination, predicting the need for surgical treatment in patients with capitellar OCD is difficult. Purpose: To perform multivariate ordered logistic regression analysis of data obtained from patients’ medical records and images on initial examination and identify the predictors of unsuccessful nonoperative management of capitellar OCD. Study Design: Cohort study (prognosis); Level of evidence, 2. Methods: This study included 245 elbows with capitellar OCD (all male; mean age, 14 years [range, 10-27 years]). Patients were divided into 3 groups comprising 148 elbows requiring an immediate operation on initial examination, 48 requiring nonsurgical treatment, and 49 requiring an operation after nonoperative management. Baseline data and radiographic parameters, such as lesion location, lesion size, modified Minami classification, radial head size, skeletal age difference between both elbows on initial examination, lesion size on computed tomography, and staging on magnetic resonance imaging, were retrospectively reviewed. Univariate and multivariate ordered logistic regression analyses of spontaneous healing of the lesion were conducted. Results: Univariate logistic regression analysis showed that radial head enlargement and skeletal age difference were significantly associated with spontaneous healing. In multivariate ordered logistic regression analysis, radial head enlargement (anteroposterior and lateral) and skeletal age difference were significant predictors of lack of spontaneous healing (odds ratio [OR], 2.76, P =.025; OR, 7.92, P =.026; and OR, 1.84, P =.0089, respectively). Conclusion: To predict spontaneous healing in the moderate stage, plain radiographs would be important to evaluate radiocapitellar congruity and skeletal age. This study showed that preoperative radiographic findings of radial head enlargement and advanced skeletal age of the throwing side compared with that of the nonthrowing side were predictors of advanced-stage capitellar OCD. Despite several limitations, the statistical significance and correlations herein provide important information on preoperative surgical planning to surgeons.

show abstract

Alteration of Stress Distribution Patterns in Symptomatic Valgus Instability of the Elbow in Baseball Players

Abstract: The information obtained from the CT images can useful for early detection of overstress conditions of the elbow joint.

Cited by 25 publications

References 26 publications

Long-term Stress Distribution Patterns Across the Ankle Joint in Soccer Players: A Computed Tomography Osteoabsorptiometry Study

Long-term Stress Distribution Patterns Across the Ankle Joint in Soccer Players: A Computed Tomography Osteoabsorptiometry Study

Stress Distribution Patterns Across the Shoulder Joint in Gymnasts: A Computed Tomography Osteoabsorptiometry Study

Predictors of Unsuccessful Nonoperative Management of Capitellar Osteochondritis Dissecans

Contact Info

Product

Resources

About