Capitellar excision and hemiarthroplasty affects elbow kinematics and stability

Sabo, Marlis T.; Shannon, Hannah L.; Deluce, Simon; Lalone, Emily A.; Ferreira, Louis M.; Johnson, Jim; King, Graham J.W.

doi:10.1016/j.jse.2011.04.019

Cited by 21 publications

(7 citation statements)

References 16 publications

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“…19 This symptom was spontaneously resolved during follow-up perhaps due to further strengthening of the ligament and muscle and remodeling of the radial head. Journal of Orthopaedic Surgery 28 (3) In the present case, the implant was fabricated from medical-grade titanium alloy (Ti-6Al-4 V) instead of other materials, such as cobalt-based alloy or stainless steel, because of its relatively lower elastic modulus which is more efficient in interface stress transfer. 20 This is likely to reduce stress shielding, enable better graft loading, encourage graft incorporation, and prevent subsequent graft resorption.…”

Section: Discussionmentioning

confidence: 99%

“…2 Loss of the lateral condyle would result in 100% of forearm loads crossing the ulnohumeral joint, raising concerns about overload of that cartilage and degenerative arthrosis. 3 The biomechanic study demonstrated that the capitellum also has a role in maintaining the valgus and rotational stability of the ulnohumeral joint. 4 Reconstruction of the capitellar and lateral condylar loss is recommended to restore the elbow kinematics and stability.…”

Section: Introductionmentioning

confidence: 99%

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The patient-specific implant created with 3D printing technology in treatment of a severe open distal humerus fracture with complete loss of the lateral column

Luenam

Kosiyatrakul

Phakdeewisetkul

et al. 2020

J Orthop Surg (Hong Kong)

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The open distal humeral fracture associated with the major loss of the articular surface and bony structure is a challenging problem for orthopedic surgeons. In this case report, we describe a case of complete missing lateral column of the distal humerus with severe articular destruction of capitellum and lateral trochlear ridge which was treated with the patient-specific implant created with three-dimensional printing technology. Apart from anatomic replacement of the articular surface, the lateral collateral ligament complex and extensor muscle which are the key soft tissue stabilizers of elbow were repaired by reattaching their bony origins to the impacted iliac crest bone graft inside the implant. Due to the favorable result at 2-year follow-up, this modality is a potentially viable surgical option in treating of the severe open distal humeral fracture associated with entire lateral condylar damage.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The patient-specific implant created with 3D printing technology in treatment of a severe open distal humerus fracture with complete loss of the lateral column

Luenam

Kosiyatrakul

Phakdeewisetkul

et al. 2020

J Orthop Surg (Hong Kong)

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“…Furthermore, it is quite difficult to replicate the anatomy of native capitellum with off-shelf implants, hence, fixation of these implants leads to increased forces on the corresponding articulating parts. Sabo et al [ 1 ] measured the contact area of spherical and hemispherical hemiarthroplasties for capitellum and found this to be 59% and 51% of the native articulation and concluded that as a result of this, radial head cartilage saw a marked increase in contact pressure relative to natural articulation. In another study [ 2 ], they concluded that the capitellum does not have a spherical surface or a circular footprint and there is substantial variability in the relationship between the height and width, and between the surface radii, that may be difficult to replicate with an off-the-shelf implant.…”

Section: Discussionmentioning

confidence: 99%

Reconstruction of Capitellar Defect using Freeze-dried Cadaveric Allograft – A Case Report

Kainth¹,

Kanvinde²

2020

JOCR

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“…In a more recent study by Sabo et al, a lateral epicondylar osteotomy was performed, and the capitellum was excised. Ten specimens were tested in pronation and supination.…”

Section: Discussionmentioning

confidence: 99%

Capitellum excision: Mechanical implications and clinical consequences

Root

Meyers

Wright

et al. 2013

Journal Orthopaedic Research

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Controversy exists regarding the optimal treatment of isolated fractures of the capitellum that are not amenable to open reduction and internal fixation. Excision of the capitellum could result in instability of the elbow, though only limited the clinical or laboratory evidence exists to support this outcome. The aim of our study was to determine if capitellum excision leads to significant instability by measuring the relative change in varus-valgus displacement of the elbow. The varus-valgus displacement was recorded in 11 cadaveric elbows before and after isolated excision of the capitellum. Specimens were testing in varus-loaded and valgus-loaded positions with and without a 1 kg weight on the forearm. The varus-valgus displacement at the elbow was measured using a 3D motion capture system. Capitellum excision did not significantly change varus-valgus displacements in either the adducted, varus, or valgus position of the elbow (p ¼ 0.80, p ¼ 0.28, p ¼ 0.51). Furthermore, the addition of the 1 kg external functional load to the forearm did not produce a significant change in the varus and valgus loaded positions (p ¼ 0.16, p ¼ 0.36). Our results demonstrate that excision of the capitellum in the setting of intact ligamentous structures does not result in significant instability in either the adducted varus loaded or valgus loaded positions of the elbow. ß

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Capitellar excision and hemiarthroplasty affects elbow kinematics and stability

Cited by 21 publications

References 16 publications

The patient-specific implant created with 3D printing technology in treatment of a severe open distal humerus fracture with complete loss of the lateral column

The patient-specific implant created with 3D printing technology in treatment of a severe open distal humerus fracture with complete loss of the lateral column

Reconstruction of Capitellar Defect using Freeze-dried Cadaveric Allograft – A Case Report

Capitellum excision: Mechanical implications and clinical consequences

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