Motion and laxity of the capitellocondylar total elbow prosthesis.

The motion and laxity of the capitellocondylar unconstrained total elbow prosthesis were assessed, with use of an electromagnetic tracking device and stimulated muscle-loading, after implantation in seventeen cadaveric elbows. The axis of motion of the elbows with the capitellocondylar implants averaged 2.1 +/- 2.3 degrees more varus angulation than that of the intact elbows. This difference may be attributed to the design of the implant, as the 5-degree-valgus humeral component used in this study has a smaller valgus inclination than the articular surface of the distal aspect of the humerus. Although the maximum valgus-varus laxity of the capitellocondylar elbow prostheses was, on the average, 4.3 +/- 2.4 degrees greater than normal (with simulated muscle-loading), the data must be interpreted in light of the fact that this in vitro study did not allow for soft-tissue healing. The prosthetic components tracked well, and there were no dislocations or malarticulations provided that appropriate soft-tissue tensioning and positioning of the components had been achieved at the time of implantation. Sectioning of either the medial or the lateral collateral ligament resulted in gross instability of the joint after capitellocondylar arthroplasty. The ulnar attachment of the medial collateral ligament was found to be vulnerable to injury during the positioning of the ulnar component of this implant.

[1]  A. Weiland,et al.  Valgus stability of the elbow , 1987, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[2]  B F Morrey,et al.  Functional anatomy of the ligaments of the elbow. , 1985, Clinical orthopaedics and related research.

[3]  J. Ruth,et al.  Capitellocondylar total elbow replacement. A long-term follow-up study. , 1992, The Journal of bone and joint surgery. American volume.

[4]  P. Rozing,et al.  Use of the Souter-Strathclyde total elbow prosthesis in patients who have rheumatoid arthritis. , 1991, The Journal of bone and joint surgery. American volume.

[5]  B F Morrey,et al.  Biomechanical study of ligaments around the elbow joint. , 1991, Clinical orthopaedics and related research.

[6]  K. An,et al.  Kinematics of semi-constrained total elbow arthroplasty. , 1992, The Journal of bone and joint surgery. British volume.

[7]  B. G. Evans,et al.  A comparison of the mechanical designs of articulating total elbow prostheses , 1988 .

[8]  D. Dennis,et al.  Capitello-Condylar total elbow arthroplasty for rheumatoid arthritis. , 1990, The Journal of arthroplasty.

[9]  F K Fuss,et al.  The ulnar collateral ligament of the human elbow joint. Anatomy, function and biomechanics. , 1991, Journal of anatomy.

[10]  B F Morrey,et al.  Valgus stability of the elbow. A definition of primary and secondary constraints. , 1991, Clinical orthopaedics and related research.

[11]  Total replacement of the elbow joint. , 1973, The Orthopedic clinics of North America.

[12]  J A Sidles,et al.  Ligament length relationships in the moving knee , 1988, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[13]  R. Dee Total replacement of the elbow joint. , 1972, Modern trends in orthopaedics.

[14]  A. Weiland,et al.  Capitellocondylar total elbow replacement. A long-term follow-up study. , 1989, The Journal of bone and joint surgery. American volume.

[15]  K. An,et al.  In vitro stability of an unconstrained total elbow prosthesis. Influence of axial loading and joint flexion angle. , 1993, The Journal of arthroplasty.