The effect of torsional moments on the posterolateral rotatory stability of a lateral ligament deficient elbow: An in vitro biomechanical investigation

Badre, Armin; Axford, David T.; Banayan, Sara; Johnson, James A.; King, Graham J.W.

doi:10.1016/j.clinbiomech.2019.05.002

Cited by 6 publications

(6 citation statements)

References 29 publications

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“…23 We observed a high frequency of additional pathologies, such as synovial folds, insertion lesions, and chondral injuries, suggesting that elbow pain may have multiple causes. 24 The statistically significant relationship between annular ligament incompetence and chondral lesions in our study is biomechanically justified by increased radiocapitellar displacement and abnormal bone-to-bone con-tact, exacerbated by repetitive movements in demanding manual labor. [17][18][19][20]25 The literature reveals that a considerable percentage of patients with refractory lateral elbow pain due to conservative treatment exhibit chondral changes in the radiocapitellar joint, contradicting previous beliefs.…”

Section: Discussionmentioning

confidence: 49%

“…We observed a high frequency of additional pathologies, such as synovial folds, insertion lesions, and chondral injuries, suggesting that elbow pain may have multiple causes 24. The statistically significant relationship between annular ligament incompetence and chondral lesions in our study is biomechanically justified by increased radiocapitellar displacement and abnormal bone-to-bone contact, exacerbated by repetitive movements in demanding manual labor 17-20,25…”

Section: Discussionmentioning

confidence: 52%

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Annular Ligament Instability

Abellán-Miralles,

Berlanga-de-Mingo,

Samaniego-Alonso

et al. 2024

Topics in Geriatric Rehabilitation

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Purpose: Lateral elbow pain is frequently attributed to epicondylalgia; yet, less common pathologies with limited literature representation exist. This study aims to delineate the diagnostic significance of alterations in the biomechanics and morphology of the annular ligament as a distinctive factor in lateral elbow pain. Methods: A retrospective observational analysis was conducted on patients surgically treated for lateral elbow pain with arthroscopic assistance from January 2015 to December 2018. Initial preoperative diagnoses primarily indicated epicondylalgia. Results: The study encompassed 82 patients (48 men, 34 women; mean age: 44.6 ± 5.3 years), with 91.46% involved in demanding manual work. Notably, 17 patients underwent surgery due to recurrent symptoms. Arthroscopic assessments revealed diverse morphological and biomechanical variations in annular ligaments, designating 36 patients with an identified incompetent annular ligament. Conclusions: Our arthroscopic study on lateral epicondylalgia cases involved a comprehensive analysis of annular ligament anatomy and radiocapitellar joint biomechanics. The formulated anatomic classification, incorporating crucial variables such as radial head coverage and ligament tension, unveiled implications for joint instability. Recognition of simultaneous pathologies, notably annular ligament lesions, signifies a potential, yet unexplored, avenue for differential diagnosis in cases of lateral elbow pain.

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Section: Discussionmentioning

confidence: 49%

Section: Discussionmentioning

confidence: 52%

Annular Ligament Instability

Abellán-Miralles,

Berlanga-de-Mingo,

Samaniego-Alonso

et al. 2024

Topics in Geriatric Rehabilitation

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“…Although this study did not investigate what happens in vivo, it highlighted the mechanical effects of the varus deformity at the elbow. Badre et al 11 have shown that application of even small amounts of external torsion on the forearm with the arm in varus position increases rotational instability. O'Driscoll et al 5 have highlighted, in their landmark paper, how PLRI can develop secondary to cubitus varus.…”

Section: Cubitus Varusmentioning

confidence: 99%

Not Kidding! Sequalae of elbow trauma in children

Lahoti¹,

Akilapa²

2021

Journal of Clinical Orthopaedics and Trauma

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Elbow injuries are common in children and while majority heal very well, some result in deformities of the elbow. Although deformities such as cubitus varus and non-progressive cubitus valgus are considered cosmetic by the paediatric orthopaedic surgeons and intentionally ignored, they are not always benign and can result in functional deficit due to instability, pain, tardy nerve palsies and osteoarthritis later in life. Similarly congenital and developmental conditions that do not cause major functional loss in childhood, become very disabling in adults due to increasing functional demands. Congenital radial head dislocation and radioulnar synostosis fall into this category. In this paper we discuss clinical presentation, treatment options and outcomes of common elbow conditions presenting later in the life.

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“…9,10 The lack of stabilizing effect of these braces may be related to the torsional moment on the elbow due to the weight of the brace with the arm in an varus position as has been shown in another biomechanical study. 20 The authors showed that application of weights as little as 400g results in significant torsional moments exacerbating the posterolateral rotatory instability of an LCL deficient elbow with the arm in the varus position. 20 Thus, the weight of our brace, which is approximately 1000 g, may have contributed to its lack of effectiveness in stabilizing an LCL deficient elbow.…”

Section: Discussionmentioning

confidence: 99%

Stabilizing effect of an elbow orthosis with an adjustable hinge axis after lateral collateral ligament injury: A biomechanical study

et al. 2022

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Background Current commercial elbow braces have a straight hinge that does not account for the native carrying angle of the elbow. The objective of this study was to determine the effectiveness of a custom-designed hinged elbow orthosis (HEO) with variable valgus angulations in stabilizing a lateral collateral ligament (LCL) deficient elbow. Methods Eight cadaveric upper extremities were mounted in an elbow motion simulator in the abducted varus gravity-loaded position. The specimens were examined before and after simulated LCL injury and then with the addition of the custom-designed HEO with 0°, 10°, and 20° of valgus angulation. Kinematic data were recorded using an electromagnetic tracking system. Results The LCL injured state with or without the brace resulted in significant increases in varus angulation of the elbow compared to the intact state in both pronation and supination ( P < 0.05). There were no significant differences in varus-valgus angulation or ulnohumeral rotation between any of the brace angles and the LCL injured state with the forearm pronated and supinated. Discussion The custom-designed HEO did not provide any additional stability to the LCL injured elbow. The varus arm position should be avoided during the rehabilitation of an LCL injured elbow even when an HEO is used.

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The effect of torsional moments on the posterolateral rotatory stability of a lateral ligament deficient elbow: An in vitro biomechanical investigation

Cited by 6 publications

References 29 publications

Annular Ligament Instability

Annular Ligament Instability

Not Kidding! Sequalae of elbow trauma in children

Stabilizing effect of an elbow orthosis with an adjustable hinge axis after lateral collateral ligament injury: A biomechanical study

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