Biomechanical Stability of Lateral Ulnar Collateral Ligament Reconstruction and Repair of the Elbow: The Role of Ligament Bracing on Gap Formation and Stabilization.
Autor: | Bachmaier, Samuel, Wijdicks, Coen A., Verma, Nikhil N., Higgins, Laurence D., Greiner, Stefan |
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Předmět: |
MEDICAL cadavers
TORQUE STATISTICS NONPARAMETRIC statistics KRUSKAL-Wallis Test ANALYSIS of variance ORTHOPEDIC surgery ELBOW joint JOINT instability ONE-way analysis of variance PLASTIC surgery REGRESSION analysis COMPARATIVE studies TREATMENT effectiveness COLLATERAL ligament DESCRIPTIVE statistics BIOMECHANICS STATISTICAL sampling DATA analysis software DATA analysis ORTHOPEDIC apparatus ALGORITHMS |
Zdroj: | American Journal of Sports Medicine; Apr2023, Vol. 51 Issue 5, p1303-1311, 9p |
Abstrakt: | Background: Augmented (internal braced) lateral ulnar collateral ligament (LUCL) repair has been biomechanically compared with reconstruction techniques in the elbow. However, LUCL repair alone has not yet been compared with augmented repair and reconstruction techniques. Hypothesis: Internal bracing of LUCL repair would improve time-zero stabilization regarding gap formation, stiffness, and residual torque as compared with repair alone and reconstruction techniques to restore native elbow stability. Study Design: Controlled laboratory study. Methods: Overall, 24 cadaveric elbows were used for either internal braced LUCL repair (Repair-IB) or single- and double-strand ligament reconstruction with triceps (Recon-TR) and palmaris longus tendon graft (Recon-PL), respectively. Laxity testing in external rotation was consecutively performed at 90° of elbow flexion on the intact, dissected, and repaired conditions and with the previously assigned techniques. First, intact elbows were loaded to 7.0-N·m external torque to evaluate time-zero ligament rotations at 2.5, 4.0, 5.5, and 7.0 N·m. Rotation-controlled cycling was performed (total of 1000 cycles) for each surgical condition. Gapping, stiffness, and residual torque were analyzed. Finally, these and 8 additional intact elbows underwent torque-to-failure testing (30 deg/min). Results: The dissected state showed the highest gap formation and lowest peak torques (P <.001). While gap formation of Repair-IB (P <.021) was significantly lower than that of repair without internal bracing at all rotation levels, gaps of Recon-PL were similar to and Recon-TR were significantly higher than those of Repair-IB except for the highest torsion level. Residual peak torques at specific rotation angles between native state and Recon-TR (α |
Databáze: | Complementary Index |
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