Universität zu Köln

Hackl, Michael ORCID: 0000-0002-6183-5621, Heinze, Nicolai, Wegmann, Kilian, Lappen, Sebastian, Leschinger, Tim ORCID: 0000-0003-1319-6949, Burkhart, Klaus Josef, Scaal, Martin and Mueller, Lars Peter (2016). The circumferential graft technique for treatment of multidirectional elbow instability: a comparative biomechanical evaluation. J. Shoulder Elbow Surg., 25 (1). S. 127 - 136. NEW YORK: MOSBY-ELSEVIER. ISSN 1058-2746

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Abstract

Background: Ligament reconstruction with a circumferential graft represents an innovative technique for treatment of multidirectional elbow instability. This biomechanical study compared the stability of the intact elbow joint with the circumferential graft technique and the conventional technique. Methods: Seven fresh frozen cadaveric elbows were evaluated for stability against valgus and varus/posterolateral rotatory forces (3 Nm) over the full range of motion. Primary stability was determined for intact specimens, after sectioning of the collateral ligaments, after applying the circumferential graft technique (box-loop), and after conventional collateral ligament reconstruction. Cyclic loading (1000 cycles) was performed to assess joint stability and stiffness of the native ligaments and the tendon grafts. Results: Primary stability of both reconstruction techniques was equal to the native specimens (P = .17.91). Sectioning of the collateral ligaments significantly increased joint instability (P < .001). The reconstruction techniques provided equal stability after 1000 cycles (P = .78). Both were inferior to the intact specimens (P = .02). Cyclic loading caused a significantly lower increase in stiffness of the native ligaments compared with the tendon grafts of either reconstruction technique (P = .001-.008). Significantly better graft stiffness was retained with the circumferential graft technique compared with conventional reconstruction (P = .04). Conclusion: Neither reconstruction technique fully reproduces the biomechanical profile of the native collateral ligaments. The circumferential graft technique seems to resist cyclic loading slightly better than the conventional reconstruction technique, yet both reconstruction techniques provide comparable stability. (C) 2016 Journal of Shoulder and Elbow Surgery Board of Trustees.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Hackl, Michael UNSPECIFIED orcid.org/0000-0002-6183-5621 UNSPECIFIED Heinze, Nicolai UNSPECIFIED UNSPECIFIED UNSPECIFIED Wegmann, Kilian UNSPECIFIED UNSPECIFIED UNSPECIFIED Lappen, Sebastian UNSPECIFIED UNSPECIFIED UNSPECIFIED Leschinger, Tim UNSPECIFIED orcid.org/0000-0003-1319-6949 UNSPECIFIED Burkhart, Klaus Josef UNSPECIFIED UNSPECIFIED UNSPECIFIED Scaal, Martin UNSPECIFIED UNSPECIFIED UNSPECIFIED Mueller, Lars Peter UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-292984
DOI:	10.1016/j.jse.2015.07.016
Journal or Publication Title:	J. Shoulder Elbow Surg.
Volume:	25
Number:	1
Page Range:	S. 127 - 136
Date:	2016
Publisher:	MOSBY-ELSEVIER
Place of Publication:	NEW YORK
ISSN:	1058-2746
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language ULNAR COLLATERAL LIGAMENT; POSTEROLATERAL ROTATORY INSTABILITY; RADIAL ULNOHUMERAL LIGAMENT; INTERFERENCE SCREW FIXATION; RECONSTRUCTION TECHNIQUES; FUNCTIONAL-ANATOMY; DOCKING TECHNIQUE; VALGUS STABILITY; LATERAL LIGAMENT; DEFICIENT ELBOW Multiple languages Orthopedics; Sport Sciences; Surgery Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/29298