scholarly journals Medial Collateral Ligament Deficiency of the Elbow Joint: A Computational Approach

2018 ◽  
Vol 5 (4) ◽  
pp. 84 ◽  
Author(s):  
Munsur Rahman ◽  
Akin Cil ◽  
Antonis Stylianou
Keyword(s):  
Medial Collateral Ligament ◽  
Elbow Joint ◽  
Surgical Planning ◽  
Computational Models ◽  
Three Dimensional ◽  
Joint Stability ◽  
Joint Models ◽  
Collateral Ligament ◽  
Joint Contact ◽  
Larger Sample

Computational elbow joint models, capable of simulating medial collateral ligament deficiency, can be extremely valuable tools for surgical planning and refinement of therapeutic strategies. The objective of this study was to investigate the effects of varying levels of medial collateral ligament deficiency on elbow joint stability using subject-specific computational models. Two elbow joint models were placed at the pronated forearm position and passively flexed by applying a vertical downward motion on humeral head. The models included three-dimensional bone geometries, multiple ligament bundles wrapped around the joint, and the discretized cartilage representation. Four different ligament conditions were simulated: All intact ligaments, isolated medial collateral ligament (MCL) anterior bundle deficiency, isolated MCL posterior bundle deficiency, and complete MCL deficiency. Minimal kinematic differences were observed for isolated anterior and posterior bundle deficient elbows. However, sectioning the entire MCL resulted in significant kinematic differences and induced substantial elbow instability. Joint contact areas were nearly similar for the intact and isolated posterior bundle deficiency. Minor differences were observed for the isolated anterior bundle deficiency, and major differences were observed for the entire MCL deficiency. Complete elbow dislocations were not observed for any ligament deficiency level. As expected, during isolated anterior bundle deficiency, the remaining posterior bundle experiences higher load and vice versa. Overall, the results indicate that either MCL anterior or posterior bundle can provide anterior elbow stability, but the anterior bundle has a somewhat bigger influence on joint kinematics and contact characteristics than posterior one. A study with a larger sample size could help to strengthen the conclusion and statistical significant.

scholarly journals Finite Element Analysis of Elbow Joint Stability by Different Flexion Angles of the Annular Ligament

2020 ◽  
Author(s):  
Guangming Xu ◽  
ZhengZhong Yang ◽  
JiYong Yang ◽  
Ziyang Liang ◽  
wei Li
Keyword(s):  
Finite Element ◽  
Medial Collateral Ligament ◽  
Contact Area ◽  
Elbow Joint ◽  
Clinical Symptoms ◽  
Elbow Flexion ◽  
Annular Ligament ◽  
Joint Stability ◽  
Collateral Ligament ◽  
Element Analysis

Abstract ObjectiveTo investigate the biomechanical effects of different flexion angles of the annular ligament on elbow joint stability. MethodsLeft elbow CT and MRI scans were chosen from a healthy volunteer, according to a previous research model. A cartilage and ligament model was constructed with SolidWorks software according to the MRI results to simulate the annular ligament during normal, loosen, and rupture conditions at different buckling angles (0, 30, 60, 90, 120). In 15 elbow models, boundary conditions were set according to the literature. The different elbow 3D finite element models were imported into ABAQUS software to calculate and analyze the load, contact area, contact stress and stress of the medial collateral ligament of the olecranon cartilage. Results1. According to the analysis results, olecranon cartilage stress values when the annular ligament under different conditions（normal、loosened、ruptured）with elbow extension, were 2.1 ± 0.18, 2.4 ± 0.75, and 2.9 ± 0.94 MPa. As the buckling angle increased, the stress value decreased; with 120 degrees of elbow flexion, the minimum stress values were 0.9 ± 0.12, 1.1 ± 0.38, and 1.2 ± 0.29 MPa. 2. When the contact surface of the olecranon cartilage was flexed from 0 to 30 degrees, the olecranon cartilage contact area significantly increased, reaching a maximum value of 254±5.35 mm, and then the contact area gradually decreased, reaching a minimum value of 176±2.62 mm when the elbow joint was flexed to 120 degrees. The results when the annular ligament was loosened and ruptured were different from those of the normal annular ligament. The maximum values were 283±4.74and 312±5.49mm at 60 degrees of elbow flexion. The contact area gradually decreased with an increase in the angle, and the minimum values were 210±3.82 and 236±6.59 mm at 120 degrees of elbow flexion. 3. When the elbow joint was extended, the maximum stress of the medial collateral ligament was 6.5±0.23, 11.5±0.78 and 18.7±0.94 MPa under different states; as the stress decreased with an increase in the angle, the corresponding values were 2.8±0.18, 4.8±0.56 and 6.2±0.72 MPa at 120 degrees of elbow flexion. ConclusionThe annular ligament plays an important role in maintaining elbow joint stability. When the annular ligament ruptures, it should be reconstructed as much as possible to avoid the elevation of stress on the surface of the medial collateral ligament of the elbow and on the annular cartilage, which may cause clinical symptoms.

The role of the posterior bundle of the medial collateral ligament in posteromedial rotatory instability of the elbow

2018 ◽  
Vol 100-B (8) ◽  
pp. 1060-1065 ◽  
Author(s):  
J-T. Hwang ◽  
M. N. Shields ◽  
L. J. Berglund ◽  
A. W. Hooke ◽  
J. S. Fitzsimmons ◽  
...  
Keyword(s):  
Contact Pressure ◽  
Medial Collateral Ligament ◽  
Lateral Collateral Ligament ◽  
Collateral Ligament ◽  
Coronoid Fracture ◽  
Rotatory Instability ◽  
Intact Group ◽  
Joint Contact ◽  
The Mean ◽  
Contact Pressures

Aims The aim of this study was to evaluate two hypotheses. First, that disruption of posterior bundle of the medial collateral ligament (PMCL) has to occur for the elbow to subluxate in cases of posteromedial rotatory instability (PMRI) and second, that ulnohumeral contact pressures increase after disruption of the PMCL. Materials and Methods Six human cadaveric elbows were prepared on a custom-designed apparatus which allowed muscle loading and passive elbow motion under gravitational varus. Joint contact pressures were measured sequentially in the intact elbow (INTACT), followed by an anteromedial subtype two coronoid fracture (COR), a lateral collateral ligament (LCL) tear (COR + LCL), and a PMCL tear (COR + LCL + PMCL). Results There was no subluxation or joint incongruity in the INTACT, COR, and COR + LCL specimens. All specimens in the COR + LCL + PMCL group subluxated under gravity-varus loads. The mean articular contact pressure of the COR + LCL group was significantly higher than those in the INTACT and the COR groups. The mean articular contact pressure of the COR + LCL + PMCL group was significantly higher than that of the INTACT group, but not higher than that of the COR + LCL group. Conclusion In the presence of an anteromedial fracture and disruption of the LCL, the posterior bundle of the MCL has to be disrupted for gross subluxation of the elbow to occur. However, elevated joint contact pressures are seen after an anteromedial fracture and LCL disruption even in the absence of such subluxation. Cite this article: Bone Joint J 2018;100-B:1060–5.

Applying a Hybrid Experimental-Computational Technique to Study Elbow Joint Ligamentous Stabilizers

2018 ◽  
Vol 140 (6) ◽  
Author(s):  
Danial Sharifi Kia ◽  
Ryan Willing
Keyword(s):  
Soft Tissue ◽  
Elbow Joint ◽  
Computational Technique ◽  
Joint Stability ◽  
Collateral Ligament ◽  
Principle Of Superposition ◽  
Flexion Extension ◽  
Joint Biomechanics ◽  
The Stability

Much of our understanding of the role of elbow ligaments to overall joint biomechanics has been developed through in vitro cadaver studies using joint motion simulators. The principle of superposition can be used to indirectly compute the force contributions of ligaments during prescribed motions. Previous studies have analyzed the contribution of different soft tissue structures to the stability of human elbow joints, but have limitations in evaluating the loads sustained by those tissues. This paper introduces a unique, hybrid experimental-computational technique for measuring and simulating the biomechanical contributions of ligaments to elbow joint kinematics and stability. in vitro testing of cadaveric joints is enhanced by the incorporation of fully parametric virtual ligaments, which are used in place of the native joint stabilizers to characterize the contribution of elbow ligaments during simple flexion–extension (FE) motions using the principle of superposition. Our results support previously reported findings that the anterior medial collateral ligament (AMCL) and the radial collateral ligament (RCL) are the primary soft tissue stabilizers for the elbow joint. Tuned virtual ligaments employed in this study were able to restore the kinematics and laxity of elbows to within 2 deg of native joint behavior. The hybrid framework presented in this study demonstrates promising capabilities in measuring the biomechanical contribution of ligamentous structures to joint stability.

The Effect of Medial Collateral Ligament Repair Tension on Elbow Joint Kinematics and Stability

2007 ◽  
Vol 32 (8) ◽  
pp. 1210-1217 ◽  
Author(s):  
J.E. Pichora ◽  
G.S. Fraser ◽  
L.F. Ferreira ◽  
J.R. Brownhill ◽  
J.A. Johnson ◽  
...  
Keyword(s):  
Medial Collateral Ligament ◽  
Elbow Joint ◽  
Joint Kinematics ◽  
Ligament Repair ◽  
Collateral Ligament

scholarly journals A Systematic Review on Selected Complications of Open-Wedge High Tibial Osteotomy from Clinical and Biomechanical Perspectives

2021 ◽  
Vol 2021 ◽  
pp. 1-14
Author(s):  
Elaheh Elyasi ◽  
Guillaume Cavalié ◽  
Antoine Perrier ◽  
Wilfrid Graff ◽  
Yohan Payan
Keyword(s):  
Systematic Review ◽  
Soft Tissue ◽  
High Tibial Osteotomy ◽  
Medial Collateral Ligament ◽  
Surgical Planning ◽  
Tibial Slope ◽  
Patellar Height ◽  
Tibial Osteotomy ◽  
Collateral Ligament ◽  
Posterior Tibial

Background. The wedge opened during high tibial osteotomy defines the alignment correction in different body planes and alters soft tissue insertions. Although multiple complications of the surgery can be correlated to this, there is still a lack of consensus on the occurrence of those complications and their cause. The current study is aimed at clarifying this problem using a combined medical and biomechanical perspective. Methods. We conducted a systematic review of the literature on selective complications of the surgery correlated with the angles of the opened wedge. Search topics covered tibial slope alteration, patellar height alteration, medial collateral ligament release, and model-based biomechanical simulations related to surgical planning or complications. Findings. The selection process with the defined inclusion/exclusion criteria led to the collection of qualitative and quantitative data from 38 articles. Medial collateral ligament tightness can be a valid complication of this surgery; however, further information about its preoperative condition seems required for better interpreting the results. The posterior tibial slope significantly increases, and the patellar height (using the Blackburne-Peel ratio) significantly decreases in the majority of the selected studies. Model-based biomechanical studies targeting surgical planning are mostly focused on the lower-limb alignment principles and tibiofemoral contact balancing rather than surgical complications. Interpretation. Increased posterior tibial slope, patellar height decrease, and medial collateral ligament tightness can occur due to alterations in different body planes and in soft tissue insertions after wedge opening. This study clarified that information about preoperative alignment in all body planes and soft-tissue conditions should be considered in order to avoid and anticipate these complications and to improve per surgery wedge adaptation. The findings and perspective of this review can contribute to improving the design of future clinical and biomechanical studies.

The medial collateral ligament of the elbow joint: Anatomy and kinematics

1998 ◽  
Vol 7 (4) ◽  
pp. 345-351 ◽  
Author(s):  
Sarah Floris ◽  
Bo S Olsen ◽  
Michel Dalstra ◽  
Jens O Søjbjerg ◽  
Otto Sneppen
Keyword(s):  
Medial Collateral Ligament ◽  
Elbow Joint ◽  
Collateral Ligament

Antebrachiocarpal luxation in a cat

2003 ◽  
Vol 16 (04) ◽  
pp. 266-70 ◽  
Author(s):  
H. Geyer ◽  
P. M. Montavon ◽  
K. Voss
Keyword(s):  
Functional Outcome ◽  
Medial Collateral Ligament ◽  
Anatomical Study ◽  
Carpal Bone ◽  
Joint Stability ◽  
Collateral Ligament ◽  
Radiocarpal Joint ◽  
Carpal Ligaments

SummaryA complete palmar antebrachiocarpal luxation due to rupture of the medial collateral ligament was diagnosed in a cat. Complete antebrachiocarpal luxation in dogs is generally associated with the disruption of multiple carpal ligaments. A comparative anatomical study of cadavers of five cats and five dogs revealed that, unlike in dogs, the medial collateral ligament in cats consists of only one branch, which extends from its dorsoproximal attachment on the radius obliquely to its palmarodistal attachment on the radial carpal bone. The oblique course of the ligament likely opposes palmar dislocation of the radial carpal bone rather than medial opening of the radiocarpal joint.In this present reported case, adequate joint stability was achieved by replacing the medial collateral ligament using two 1.5-mm cortical screws and a3.5 (metric gauge) polypropylene figure-8 suture sling. Minimal signs of osteoarthrosis developed three months after surgery, but functional outcome at six months was very satisfactory.

scholarly journals Medial collateral ligament reconstruction during TKA: a new approach and surgical technique

Joints ◽  
2015 ◽  
Vol 03 (04) ◽  
pp. 215-217 ◽  
Author(s):  
Paolo Adravanti ◽  
Francesco Dini ◽  
Giuseppe Calafiore ◽  
Michele Rosa
Keyword(s):  
Medial Collateral Ligament ◽  
Ligament Reconstruction ◽  
Knee Stability ◽  
Joint Stability ◽  
Collateral Ligament ◽  
New Approach ◽  
Medial Collateral Ligament Reconstruction ◽  
Total Knee ◽  
Reconstructive Technique

Medial collateral ligament (MCL) injuries during total knee arthroplasty are rare but severe complications. They can be treated conservatively, by increasing prosthetic constraint, by using a thicker polyethylene insert, or by directly suturing the ligament. A prosthesis is successful to the extent that it ensures long-term knee stability. We describe our surgical approach to the restoration of knee joint stability in MCL deficiency: a reconstructive technique using the semitendinosus tendon.

scholarly journals Role of the oblique ligament in the integrity of the medial collateral ligament of the canine elbow joint

2007 ◽  
Vol 59 (1) ◽  
pp. 127-133
Author(s):  
D. Oliveira ◽  
S.M. Baraldi-Artoni ◽  
A.C. Shimano ◽  
J.R. Rossi ◽  
M.C.H. Tovar
Keyword(s):  
Medial Collateral Ligament ◽  
Elbow Joint ◽  
Tensile Strain ◽  
Collagen Fibrils ◽  
Collateral Ligament ◽  
The Third ◽  
Reticular Pattern ◽  
The Mean ◽  
Insertion Area

It was studied the arrangement of the collagen fibrils of the medial collateral ligament of the canine elbow joint and evaluated its diameter, when it was isolated or associated to the oblique ligament and loaded in tension until failure. Eighteen joints were divided in three groups. The first group had the medial collateral ligament collected and not loaded, the second group had the medial collateral ligament tested separately and the third group had both ligaments associately tested. Medial collateral ligament not submitted to strain presented a wavy and reticular pattern of the collagen fibers, which was not totally destroyed when it was loaded associated to the oblique ligament, and totally loses the reticular pattern when stretched separately. When the medial collateral ligament was loaded in tension separately, the mean collagen fibrils diameter increased in relation to the group not submitted to the tensile strain. Associated to the oblique ligament, the mean collagen fibrils diameter was the largest in the insertion area and the smallest in the mid-substance, in relation to the other groups. It was concluded that the oblique ligament could favor the integrity of the medial collateral ligament insertion area, facilitating its reconstruction after lesion with larger efficiency.

scholarly journals Quantifying Muscle Forces and Joint Loading During Hip Exercises Performed With and Without an Elastic Resistance Band

2021 ◽  
Vol 3 ◽  
Author(s):  
Callum Buehler ◽  
Willi Koller ◽  
Florentina De Comtes ◽  
Hans Kainz
Keyword(s):  
Hip Joint ◽  
Three Dimensional ◽  
Hip Osteoarthritis ◽  
Contact Forces ◽  
Muscle Forces ◽  
Joint Stability ◽  
Joint Loading ◽  
Expert Opinions ◽  
Elastic Resistance ◽  
Joint Contact

An increase in hip joint contact forces (HJCFs) is one of the main contributing mechanical causes of hip joint pathologies, such as hip osteoarthritis, and its progression. The strengthening of the surrounding muscles of the joint is a way to increase joint stability, which results in the reduction of HJCF. Most of the exercise recommendations are based on expert opinions instead of evidence-based facts. This study aimed to quantify muscle forces and joint loading during rehabilitative exercises using an elastic resistance band (ERB). Hip exercise movements of 16 healthy volunteers were recorded using a three-dimensional motion capture system and two force plates. All exercises were performed without and with an ERB and two execution velocities. Hip joint kinematics, kinetics, muscle forces, and HJCF were calculated based on the musculoskeletal simulations in OpenSim. Time-normalized waveforms of the different exercise modalities were compared with each other and with reference values found during walking. The results showed that training with an ERB increases both target muscle forces and HJCF. Furthermore, the ERB reduced the hip joint range of motion during the exercises. The type of ERB used (soft vs. stiff ERB) and the execution velocity of the exercise had a minor impact on the peak muscle forces and HJCF. The velocity of exercise execution, however, had an influence on the total required muscle force. Performing hip exercises without an ERB resulted in similar or lower peak HJCF and lower muscle forces than those found during walking. Adding an ERB during hip exercises increased the peak muscle and HJCF but the values remained below those found during walking. Our workflow and findings can be used in conjunction with future studies to support exercise design.

Sign in / Sign up

Export Citation Format

Share Document