Clinics in Shoulder and Elbow

대한견·주관절의학회 (Korean Shoulder and Elbow Society)
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Anterolateral rotatory instability of the elbow: a possible etiology of primary osteoarthritis

  • Young-Bok Kim (Department of Orthopedic Surgery, Mayo Clinic) ;
  • James S Fitzsimmons (Department of Orthopedic Surgery, Mayo Clinic) ;
  • Enrico Bellato (Department of Orthopedic Surgery, Mayo Clinic) ;
  • Shawn W O'Driscoll (Department of Orthopedic Surgery, Mayo Clinic) ;
  • Hyo Seok Jang (Department of Orthopedic Surgery, Haeundae Paik Hospital, College of Medicine, Inje University) ;
  • Dae-Wook Kim (Department of Orthopedic Surgery, Haeundae Paik Hospital, College of Medicine, Inje University)
  • 투고 : 2024.05.21
  • 심사 : 2024.09.12
  • 발행 : 2024.12.01
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초록

Background: The purpose of this study is to describe anterolateral rotatory instability (ALRI) as a possible etiology of primary osteoarthritis (OA) of the elbow. Methods: We examined 76 fresh frozen cadaveric elbows (male:female, 56:20; mean age, 81 years) for patterns of cartilage erosion that could be due to ALRI. These included erosions on the lateral trochlear ridge (LTR) lesion, crescent rim of the radial head (RC) lesion or the ventral capitellum (VC) lesion. The extent and location of the lesions were mapped by image processing of photographs of the humeral and radial articular surfaces, and the degeneration of the articular surface was graded. Results: Ten of 76 specimens (13%) had one or more lesions consistent with ALRI. LTR lesions were most common and were seen in 10 of 10 specimens (100%), typically involving the distal 30% of the LTR. RC lesions were seen in 9 of 10 and were located on anteromedial crescent of the radial head ranging from 6 to 10 o'clock. VC lesions were seen in 8 of 10 specimens directed anteroinferiorly about 60° to the long axis of the humerus. Conclusions: ALRI is a possible mechanism initiating primary OA of the elbow. It has a characteristic pattern of triple lesions involving the LTR, the RC, and the VC. Level of evidence: IV.

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과제정보

We would like to express our gratitude to Dentium (Seoul, Korea) for their assistance with the reconstruction of the finite element models and virtual surgery using MIMICS Research 22.0, 3-matic 14, NRecon, and Solidworks 2019. Additionally, we would like to thank Tae Sung S&E (Seoul, Korea) for their technical support with the operation of Ansys software, and TDM (Seoul, Korea) for providing the three-dimensional computer-aided design (CAD) file of a cannulated screw with a 6.5 thread diameter. This research was supported by a grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (No. HI22C0494), and the National Research Foundation of Korea (NRF) grant funded by the Korea government (MSIT) (No. 2022R1G1A1003299). No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.

참고문헌

  1. Adla DN, Stanley D. Primary elbow osteoarthritis: an updated review. Shoulder Elb 2011;3:41–8. https://doi.org/10.1111/j.1758-5740.2010.00089.x
  2. Gramstad GD, Galatz LM. Management of elbow osteoarthritis. J Bone Joint Surg Am 2006;88:421–30. https://doi.org/10.2106/00004623-200602000-00025
  3. Ahrens PM, Redfern DR, Forester AJ. Patterns of articular wear in the cadaveric elbow joint. J Shoulder Elbow Surg 2001;10:52–6. https://doi.org/10.1067/mse.2001.109382
  4. Goodfellow JW, Bullough PG. The pattern of ageing of the articular cartilage of the elbow joint. J Bone Joint Surg Br 1967;49:175–81. https://doi.org/10.1302/0301-620X.49B1.175
  5. Jeon IH, Chun JM, Lee CS, et al. Zona conoidea of the elbow: another articulation between the radial head and lateral trochlear of the elbow. J Bone Joint Surg Br 2012;94:517–22. https://doi.org/10.1302/0301-620X.94B4.27842
  6. Murata H, Ikuta Y, Murakami T. An anatomic investigation of the elbow joint, with special reference to aging of the articular cartilage. J Shoulder Elbow Surg 1993;2:175–81. https://doi.org/10.1016/1058-2746(93)90060-T
  7. O'Driscoll SW, Bell DF, Morrey BF. Posterolateral rotatory instability of the elbow. J Bone Joint Surg Am 1991;73:440–6. https://doi.org/10.2106/00004623-199173030-00015
  8. O'Driscoll SW, Jupiter JB, King GJ, Hotchkiss RN, Morrey BF. The unstable elbow. Instr Course Lect 2001;50:89–102.
  9. Soubeyrand M, Assabah B, Bégin M, Laemmel E, Dos Santos A, Crézé M. Pronation and supination of the hand: anatomy and biomechanics. Hand Surg Rehabil 2017;36:2–11. https://doi.org/10.1016/j.hansur.2016.09.012
  10. Hall SJ. Basic biomechanics. 7th ed. McGraw-Hill Education; 2015.
  11. Marchese SS, Di Bella P, Sessa E, Donato S, Bramanti P. The spasticity evaluation test (SeT): a pilot study. J Rehabil Res Dev 2001;38:93–100.
  12. Loss JF, Candotti CT. Comparative study between two elbow flexion exercises using the estimated resultant muscle force. Braz J Phys Ther 2008;12:502–10. https://doi.org/10.1590/S1413-35552008005000011
  13. Callaway GH, Field LD, Deng XH, et al. Biomechanical evaluation of the medial collateral ligament of the elbow. J Bone Joint Surg Am 1997;79:1223–31. https://doi.org/10.2106/00004623-199708000-00015
  14. King GJ, Morrey BF, An KN. Stabilizers of the elbow. J Shoulder Elbow Surg 1993;2:165–74. https://doi.org/10.1016/S1058-2746(09)80053-0
  15. Bellato E, Fitzsimmons JS, Kim Y, et al. Articular contact area and pressure in posteromedial rotatory instability of the elbow. J Bone Joint Surg Am 2018;100:e34. https://doi.org/10.2106/JBJS.16.01321
  16. Pollock JW, Brownhill J, Ferreira LM, McDonald CP, Johnson JA, King GJ. Effect of the posterior bundle of the medial collateral ligament on elbow stability. J Hand Surg Am 2009;34:116–23. https://doi.org/10.1016/j.jhsa.2008.09.016
  17. Golan EJ, Shukla DR, Nasser P, Hausman M. Isolated ligamentous injury can cause posteromedial elbow instability: a cadaveric study. J Shoulder Elbow Surg 2016;25:2019–24. https://doi.org/10.1016/j.jse.2016.04.022
  18. Gluck MJ, Beck CM, Golan EJ, Nasser P, Shukla DR, Hausman MR. Varus posteromedial rotatory instability: a biomechanical analysis of posterior bundle of the medial ulnar collateral ligament reconstruction. J Shoulder Elbow Surg 2018;27:1317–25. https://doi.org/10.1016/j.jse.2018.02.058
  19. Dzugan SS, Savoie FH 3rd, Field LD, O'Brien MJ, You Z. Acute radial ulno-humeral ligament injury in patients with chronic lateral epicondylitis: an observational report. J Shoulder Elbow Surg 2012;21:1651–5. https://doi.org/10.1016/j.jse.2012.04.008
  20. Kalainov DM, Cohen MS. Posterolateral rotatory instability of the elbow in association with lateral epicondylitis: a report of three cases. J Bone Joint Surg Am 2005;87:1120–5. https://doi.org/10.2106/JBJS.D.02293
  21. Ahmad CS, Park MC, Elattrache NS. Elbow medial ulnar collateral ligament insufficiency alters posteromedial olecranon contact. Am J Sports Med 2004;32:1607–12. https://doi.org/10.1177/0363546503263149
  22. Stanley D. Prevalence and etiology of symptomatic elbow osteoarthritis. J Shoulder Elbow Surg 1994;3:386–9. https://doi.org/10.1016/S1058-2746(09)80024-4
  23. Lim YW, van Riet RP, Mittal R, Bain GI. Pattern of osteophyte distribution in primary osteoarthritis of the elbow. J Shoulder Elbow Surg 2008;17:963–6. https://doi.org/10.1016/j.jse.2008.03.012
  24. Dalal S, Bull M, Stanley D. Radiographic changes at the elbow in primary osteoarthritis: a comparison with normal aging of the elbow joint. J Shoulder Elbow Surg 2007;16:358–61. https://doi.org/10.1016/j.jse.2006.08.005