Hackl, Michael ORCID: 0000-0002-6183-5621, Wegmann, Kilian, Kahmann, Stephanie L., Heinze, Nicolai, Staat, Manfred ORCID: 0000-0003-4363-6570, Neiss, Wolfram F., Scaal, Martin and Mueller, Lars P. (2017). Radial shortening osteotomy reduces radiocapitellar contact pressures while preserving valgus stability of the elbow. Knee Surg. Sports Traumatol. Arthrosc., 25 (7). S. 2280 - 2289. NEW YORK: SPRINGER. ISSN 1433-7347

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Abstract

Shortening osteotomy of the proximal radius might represent a potential salvage procedure in symptomatic radiocapitellar osteoarthritis, which could decrease radiocapitellar load while preserving the native radial head. In an in-vitro biomechanical investigation, we sought to determine whether shortening osteotomy of the proximal radius (1) decreases the radiocapitellar joint pressure upon axial loading and (2) retains valgus stability of the elbow. In addition, the anatomic configuration of the lesser sigmoid notch was evaluated to assess possible contraindications. Axial loading (0-400 N) and valgus torque (7.5 N m) over the full range of motion were applied to 14 fresh-frozen specimens before and after shortening osteotomy of the proximal radius by 2.5 mm. Radiocapitellar and ulnohumeral load distribution during axial compression was evaluated using a digital pressure mapping sensor. Valgus displacement was analyzed with a 3D camera system. The inclination angle (alpha) of the lesser sigmoid notch was assessed via 50 CT scans. Up to axial loading of 250 N, shortening osteotomy caused a significant decrease in radiocapitellar contact pressures (p < 0.041). Valgus stability of specimens did not differ before and after shortening osteotomy (n.s.). The mean inclination angle (alpha) of the lesser sigmoid notch was 11.3A degrees +/- 6.3A degrees. 46% had an inclination angle of <= 10A degrees (type I). 46% had an inclination angle of 11A degrees-20A degrees (type II). In 8%, the inclination angle was > 20A degrees (type III). Shortening osteotomy of the proximal radius can decrease radiocapitellar contact pressures during axial loading of up to 250 N. Primary valgus stability is not relevantly influenced by this procedure. In few patients, shortening osteotomy may cause radioulnar impingement of the radial head at the distal edge of the lesser sigmoid notch due to an inclination angle of > 20A degrees. Shortening osteotomy might be a promising treatment option to decrease pain levels in case of isolated radiocapitellar osteoarthritis.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Hackl, MichaelUNSPECIFIEDorcid.org/0000-0002-6183-5621UNSPECIFIED
Wegmann, KilianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kahmann, Stephanie L.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Heinze, NicolaiUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Staat, ManfredUNSPECIFIEDorcid.org/0000-0003-4363-6570UNSPECIFIED
Neiss, Wolfram F.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Scaal, MartinUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mueller, Lars P.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-226711
DOI: 10.1007/s00167-017-4468-z
Journal or Publication Title: Knee Surg. Sports Traumatol. Arthrosc.
Volume: 25
Number: 7
Page Range: S. 2280 - 2289
Date: 2017
Publisher: SPRINGER
Place of Publication: NEW YORK
ISSN: 1433-7347
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
ULNAR COLLATERAL LIGAMENT; HEAD FRACTURES; LONG-TERM; INTEROSSEOUS MEMBRANE; FORCE TRANSMISSION; FOLLOW-UP; JOINT; ARTHROPLASTY; REPLACEMENT; RESECTIONMultiple languages
Orthopedics; Sport Sciences; SurgeryMultiple languages
Refereed: Yes
URI: http://kups.ub.uni-koeln.de/id/eprint/22671

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