Highlights
- •Ulnohumeral joint cartilage relaxation contact force can be measured.
- •Ulnohumeral contact force increases with elbow supination and flexion.
- •Radial head arthroplasty overstuffing increases ulnohumeral contact force.
- •Ulnohumeral contact force can be measured without destroying static joint stabilizers.
Abstract
Introduction
Radiocapitellar joint arthroplasty is a commonly performed procedure, which often
leads to early failure or instability. Few studies assess the effect of radiocapitellar
joint arthroplasty on the ulnohumeral joint. We hypothesized that static forces of
contact (compressing cartilage, or cartilage relaxation contact force) would reveal
the effect of varying radial head implant size and elbow position on the ulnohumeral
joint.
Methods
A minimally–invasive method of measuring cartilage relaxation contact force was utilized
in 10 fresh-frozen human cadaveric specimens that did not require significant dissection
or intraarticular sensor placement. Specimens were rigidly fixed in various positions
of elbow flexion and forearm pronosupination with increasing radial head implant lengths.
Uniaxial distracting forces were applied and displacement was repeatedly measured
with resultant best-fit polynomial curves to determine inflections corresponding to
the force required to overcome static cartilage relaxation as in previous work.
Findings
Baseline mean (intra-cadaver) cartilage relaxation contact force was 11.8 N (standard
error of the mean = 0.3) at 90° of elbow flexion and neutral rotation. There was little
variation within specimens (Intraclass correlation coefficient > 0.94). Cartilage
relaxation contact force increased at the ulnohumeral joint with radial head implant
overstuffing (> 4 mm, P < 0.05) and elbow flexion (120°, P < 0.001). Pronosupination altered cartilage relaxation contact force in an implant-length
independent manner (P < 0.05).
Interpretation
Radiocapitellar joint arthroplasty implant length and elbow joint position independently
contribute to increased cartilage relaxation contact force at the ulnohumeral joint.
This further supports attempts at anatomic reconstruction of the radiocapitellar joint
to prevent pathologic ulnohumeral joint loading.
Keywords
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Article Info
Publication History
Published online: February 03, 2021
Accepted:
January 27,
2021
Received in revised form:
January 22,
2021
Received:
August 15,
2019
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2021 Published by Elsevier Ltd.
