Annular ligament reconstruction with the superficial head of the brachialis: surgical technique and biomechanical evaluation
Purpose The purpose of this study was to perform biomechanical testing of annular ligament (AL) reconstruction using the superficial head of the brachialis tendon (SHBT) as a distally based tendon graft. We hypothesized that posterior translation of the radial head following AL reconstruction with a...
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| Veröffentlicht in: | Surgical and radiologic anatomy (English ed.) 2017-06, Vol.39 (6), p.585-591 |
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| creator | Hackl, Michael Wegmann, Kilian Ries, Christian Lappen, Sebastian Scaal, Martin Müller, Lars Peter |
| description | Purpose
The purpose of this study was to perform biomechanical testing of annular ligament (AL) reconstruction using the superficial head of the brachialis tendon (SHBT) as a distally based tendon graft. We hypothesized that posterior translation of the radial head following AL reconstruction with an SHBT graft does not significantly differ from intact specimens.
Methods
Six fresh-frozen elbow specimens were used. The stability of the radial head against posterior translation forces (30 N) was evaluated in 0°, 45°, 90° and 120° of elbow flexion. Posterior translation was obtained for the intact AL, the sectioned AL and the reconstructed AL. Cyclic loading (100 cycles) in 90° of elbow flexion was performed for the intact and the reconstructed AL.
Results
Posterior translation of the radial head decreased during elbow flexion in native specimens. Sectioning of the AL significantly increased instability over the full range of motion. AL reconstruction with the SHBT restored the stability of the proximal radius but—other than the native AL—was not influenced by elbow flexion. In 120° of flexion the native AL provided significantly more stability when compared to the reconstructed AL. Cyclic loading did not provide significant differences between native and reconstructed specimens.
Conclusions
We provide a feasible technique for AL reconstruction using the SHBT. The biomechanical results obtained in this study confirm the efficacy of the procedure. AL reconstruction restores the stability of the proximal radius, yet it cannot fully mimic the complex features of the intact AL. |
| doi_str_mv | 10.1007/s00276-016-1774-y |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1837281954</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1902056483</sourcerecordid><originalsourceid>FETCH-LOGICAL-c372t-b88e6497bf12cd16e79f2dd6dcc6ec5d9344a87fd09f76531b13820b64faac653</originalsourceid><addsrcrecordid>eNp1kc2LFDEQxYMo7rj6B3iRgBcvral0dz68LYtfsOBFzyGdVKazdKfHpFsZ8I83s7OKCJ4KXv3q1YNHyHNgr4Ex-aYwxqVoGIgGpOya4wOyAy51o3qQD8mO6ZY1wFp1QZ6UcssY6wHUY3LBpeJcaLkjP69S2iab6RT3dsa00oxuSWXNm1vjkuiPuI50HZGW7YA5RBftREe0ni7hTh-ydWMVY3lbmbyPrgIrujHFbxtSmzwd4jJXwaa7HX6302ZP5k_Jo2Cngs_u5yX5-v7dl-uPzc3nD5-ur24a10q-NoNSKDothwDceRAodeDeC--cQNd73XadVTJ4poMUfQsDtIqzQXTBWleFS_Lq7HvIS81UVjPH4nCabMJlKwZU_aNA911FX_6D3i5bTjWdAc0460Wn2krBmXJ5KSVjMIccZ5uPBpg5VWPO1ZhajTlVY4715sW98zbM6P9c_O6iAvwMlLpKe8x_vf6v6y_2x5xU</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1902056483</pqid></control><display><type>article</type><title>Annular ligament reconstruction with the superficial head of the brachialis: surgical technique and biomechanical evaluation</title><source>MEDLINE</source><source>SpringerLink Journals</source><creator>Hackl, Michael ; Wegmann, Kilian ; Ries, Christian ; Lappen, Sebastian ; Scaal, Martin ; Müller, Lars Peter</creator><creatorcontrib>Hackl, Michael ; Wegmann, Kilian ; Ries, Christian ; Lappen, Sebastian ; Scaal, Martin ; Müller, Lars Peter</creatorcontrib><description>Purpose
The purpose of this study was to perform biomechanical testing of annular ligament (AL) reconstruction using the superficial head of the brachialis tendon (SHBT) as a distally based tendon graft. We hypothesized that posterior translation of the radial head following AL reconstruction with an SHBT graft does not significantly differ from intact specimens.
Methods
Six fresh-frozen elbow specimens were used. The stability of the radial head against posterior translation forces (30 N) was evaluated in 0°, 45°, 90° and 120° of elbow flexion. Posterior translation was obtained for the intact AL, the sectioned AL and the reconstructed AL. Cyclic loading (100 cycles) in 90° of elbow flexion was performed for the intact and the reconstructed AL.
Results
Posterior translation of the radial head decreased during elbow flexion in native specimens. Sectioning of the AL significantly increased instability over the full range of motion. AL reconstruction with the SHBT restored the stability of the proximal radius but—other than the native AL—was not influenced by elbow flexion. In 120° of flexion the native AL provided significantly more stability when compared to the reconstructed AL. Cyclic loading did not provide significant differences between native and reconstructed specimens.
Conclusions
We provide a feasible technique for AL reconstruction using the SHBT. The biomechanical results obtained in this study confirm the efficacy of the procedure. AL reconstruction restores the stability of the proximal radius, yet it cannot fully mimic the complex features of the intact AL.</description><identifier>ISSN: 0930-1038</identifier><identifier>EISSN: 1279-8517</identifier><identifier>DOI: 10.1007/s00276-016-1774-y</identifier><identifier>PMID: 27822697</identifier><language>eng</language><publisher>Paris: Springer Paris</publisher><subject><![CDATA[Aged ; Aged, 80 and over ; Anatomy ; Anatomy & physiology ; Biomechanical Phenomena ; Biomechanics ; Cadaver ; Elbow ; Elbow - anatomy & histology ; Elbow - physiology ; Elbow - surgery ; Humans ; Imaging ; Ligaments ; Ligaments, Articular - anatomy & histology ; Ligaments, Articular - physiology ; Ligaments, Articular - surgery ; Medicine ; Medicine & Public Health ; Original Article ; Orthopedics ; Radiology ; Radius - anatomy & histology ; Radius - physiology ; Range of Motion, Articular - physiology ; Reconstructive Surgical Procedures ; Sectioning ; Skin & tissue grafts ; Surgery ; Tendons - anatomy & histology ; Tendons - physiology ; Tendons - surgery ; Translation]]></subject><ispartof>Surgical and radiologic anatomy (English ed.), 2017-06, Vol.39 (6), p.585-591</ispartof><rights>Springer-Verlag France 2016</rights><rights>Surgical and Radiologic Anatomy is a copyright of Springer, 2017.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c372t-b88e6497bf12cd16e79f2dd6dcc6ec5d9344a87fd09f76531b13820b64faac653</citedby><cites>FETCH-LOGICAL-c372t-b88e6497bf12cd16e79f2dd6dcc6ec5d9344a87fd09f76531b13820b64faac653</cites><orcidid>0000-0002-6183-5621</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00276-016-1774-y$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00276-016-1774-y$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27822697$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hackl, Michael</creatorcontrib><creatorcontrib>Wegmann, Kilian</creatorcontrib><creatorcontrib>Ries, Christian</creatorcontrib><creatorcontrib>Lappen, Sebastian</creatorcontrib><creatorcontrib>Scaal, Martin</creatorcontrib><creatorcontrib>Müller, Lars Peter</creatorcontrib><title>Annular ligament reconstruction with the superficial head of the brachialis: surgical technique and biomechanical evaluation</title><title>Surgical and radiologic anatomy (English ed.)</title><addtitle>Surg Radiol Anat</addtitle><addtitle>Surg Radiol Anat</addtitle><description>Purpose
The purpose of this study was to perform biomechanical testing of annular ligament (AL) reconstruction using the superficial head of the brachialis tendon (SHBT) as a distally based tendon graft. We hypothesized that posterior translation of the radial head following AL reconstruction with an SHBT graft does not significantly differ from intact specimens.
Methods
Six fresh-frozen elbow specimens were used. The stability of the radial head against posterior translation forces (30 N) was evaluated in 0°, 45°, 90° and 120° of elbow flexion. Posterior translation was obtained for the intact AL, the sectioned AL and the reconstructed AL. Cyclic loading (100 cycles) in 90° of elbow flexion was performed for the intact and the reconstructed AL.
Results
Posterior translation of the radial head decreased during elbow flexion in native specimens. Sectioning of the AL significantly increased instability over the full range of motion. AL reconstruction with the SHBT restored the stability of the proximal radius but—other than the native AL—was not influenced by elbow flexion. In 120° of flexion the native AL provided significantly more stability when compared to the reconstructed AL. Cyclic loading did not provide significant differences between native and reconstructed specimens.
Conclusions
We provide a feasible technique for AL reconstruction using the SHBT. The biomechanical results obtained in this study confirm the efficacy of the procedure. AL reconstruction restores the stability of the proximal radius, yet it cannot fully mimic the complex features of the intact AL.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Anatomy</subject><subject>Anatomy & physiology</subject><subject>Biomechanical Phenomena</subject><subject>Biomechanics</subject><subject>Cadaver</subject><subject>Elbow</subject><subject>Elbow - anatomy & histology</subject><subject>Elbow - physiology</subject><subject>Elbow - surgery</subject><subject>Humans</subject><subject>Imaging</subject><subject>Ligaments</subject><subject>Ligaments, Articular - anatomy & histology</subject><subject>Ligaments, Articular - physiology</subject><subject>Ligaments, Articular - surgery</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Original Article</subject><subject>Orthopedics</subject><subject>Radiology</subject><subject>Radius - anatomy & histology</subject><subject>Radius - physiology</subject><subject>Range of Motion, Articular - physiology</subject><subject>Reconstructive Surgical Procedures</subject><subject>Sectioning</subject><subject>Skin & tissue grafts</subject><subject>Surgery</subject><subject>Tendons - anatomy & histology</subject><subject>Tendons - physiology</subject><subject>Tendons - surgery</subject><subject>Translation</subject><issn>0930-1038</issn><issn>1279-8517</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp1kc2LFDEQxYMo7rj6B3iRgBcvral0dz68LYtfsOBFzyGdVKazdKfHpFsZ8I83s7OKCJ4KXv3q1YNHyHNgr4Ex-aYwxqVoGIgGpOya4wOyAy51o3qQD8mO6ZY1wFp1QZ6UcssY6wHUY3LBpeJcaLkjP69S2iab6RT3dsa00oxuSWXNm1vjkuiPuI50HZGW7YA5RBftREe0ni7hTh-ydWMVY3lbmbyPrgIrujHFbxtSmzwd4jJXwaa7HX6302ZP5k_Jo2Cngs_u5yX5-v7dl-uPzc3nD5-ur24a10q-NoNSKDothwDceRAodeDeC--cQNd73XadVTJ4poMUfQsDtIqzQXTBWleFS_Lq7HvIS81UVjPH4nCabMJlKwZU_aNA911FX_6D3i5bTjWdAc0460Wn2krBmXJ5KSVjMIccZ5uPBpg5VWPO1ZhajTlVY4715sW98zbM6P9c_O6iAvwMlLpKe8x_vf6v6y_2x5xU</recordid><startdate>20170601</startdate><enddate>20170601</enddate><creator>Hackl, Michael</creator><creator>Wegmann, Kilian</creator><creator>Ries, Christian</creator><creator>Lappen, Sebastian</creator><creator>Scaal, Martin</creator><creator>Müller, Lars Peter</creator><general>Springer Paris</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7P</scope><scope>NAPCQ</scope><scope>PHGZM</scope><scope>PHGZT</scope><scope>PJZUB</scope><scope>PKEHL</scope><scope>PPXIY</scope><scope>PQEST</scope><scope>PQGLB</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-6183-5621</orcidid></search><sort><creationdate>20170601</creationdate><title>Annular ligament reconstruction with the superficial head of the brachialis: surgical technique and biomechanical evaluation</title><author>Hackl, Michael ; Wegmann, Kilian ; Ries, Christian ; Lappen, Sebastian ; Scaal, Martin ; Müller, Lars Peter</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c372t-b88e6497bf12cd16e79f2dd6dcc6ec5d9344a87fd09f76531b13820b64faac653</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Anatomy</topic><topic>Anatomy & physiology</topic><topic>Biomechanical Phenomena</topic><topic>Biomechanics</topic><topic>Cadaver</topic><topic>Elbow</topic><topic>Elbow - anatomy & histology</topic><topic>Elbow - physiology</topic><topic>Elbow - surgery</topic><topic>Humans</topic><topic>Imaging</topic><topic>Ligaments</topic><topic>Ligaments, Articular - anatomy & histology</topic><topic>Ligaments, Articular - physiology</topic><topic>Ligaments, Articular - surgery</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Original Article</topic><topic>Orthopedics</topic><topic>Radiology</topic><topic>Radius - anatomy & histology</topic><topic>Radius - physiology</topic><topic>Range of Motion, Articular - physiology</topic><topic>Reconstructive Surgical Procedures</topic><topic>Sectioning</topic><topic>Skin & tissue grafts</topic><topic>Surgery</topic><topic>Tendons - anatomy & histology</topic><topic>Tendons - physiology</topic><topic>Tendons - surgery</topic><topic>Translation</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hackl, Michael</creatorcontrib><creatorcontrib>Wegmann, Kilian</creatorcontrib><creatorcontrib>Ries, Christian</creatorcontrib><creatorcontrib>Lappen, Sebastian</creatorcontrib><creatorcontrib>Scaal, Martin</creatorcontrib><creatorcontrib>Müller, Lars Peter</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biological Science Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest Central (New)</collection><collection>ProQuest One Academic (New)</collection><collection>ProQuest Health & Medical Research Collection</collection><collection>ProQuest One Academic Middle East (New)</collection><collection>ProQuest One Health & Nursing</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Applied & Life Sciences</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Surgical and radiologic anatomy (English ed.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hackl, Michael</au><au>Wegmann, Kilian</au><au>Ries, Christian</au><au>Lappen, Sebastian</au><au>Scaal, Martin</au><au>Müller, Lars Peter</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Annular ligament reconstruction with the superficial head of the brachialis: surgical technique and biomechanical evaluation</atitle><jtitle>Surgical and radiologic anatomy (English ed.)</jtitle><stitle>Surg Radiol Anat</stitle><addtitle>Surg Radiol Anat</addtitle><date>2017-06-01</date><risdate>2017</risdate><volume>39</volume><issue>6</issue><spage>585</spage><epage>591</epage><pages>585-591</pages><issn>0930-1038</issn><eissn>1279-8517</eissn><abstract>Purpose
The purpose of this study was to perform biomechanical testing of annular ligament (AL) reconstruction using the superficial head of the brachialis tendon (SHBT) as a distally based tendon graft. We hypothesized that posterior translation of the radial head following AL reconstruction with an SHBT graft does not significantly differ from intact specimens.
Methods
Six fresh-frozen elbow specimens were used. The stability of the radial head against posterior translation forces (30 N) was evaluated in 0°, 45°, 90° and 120° of elbow flexion. Posterior translation was obtained for the intact AL, the sectioned AL and the reconstructed AL. Cyclic loading (100 cycles) in 90° of elbow flexion was performed for the intact and the reconstructed AL.
Results
Posterior translation of the radial head decreased during elbow flexion in native specimens. Sectioning of the AL significantly increased instability over the full range of motion. AL reconstruction with the SHBT restored the stability of the proximal radius but—other than the native AL—was not influenced by elbow flexion. In 120° of flexion the native AL provided significantly more stability when compared to the reconstructed AL. Cyclic loading did not provide significant differences between native and reconstructed specimens.
Conclusions
We provide a feasible technique for AL reconstruction using the SHBT. The biomechanical results obtained in this study confirm the efficacy of the procedure. AL reconstruction restores the stability of the proximal radius, yet it cannot fully mimic the complex features of the intact AL.</abstract><cop>Paris</cop><pub>Springer Paris</pub><pmid>27822697</pmid><doi>10.1007/s00276-016-1774-y</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-6183-5621</orcidid></addata></record> |
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| ispartof | Surgical and radiologic anatomy (English ed.), 2017-06, Vol.39 (6), p.585-591 |
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| subjects | Aged Aged, 80 and over Anatomy Anatomy & physiology Biomechanical Phenomena Biomechanics Cadaver Elbow Elbow - anatomy & histology Elbow - physiology Elbow - surgery Humans Imaging Ligaments Ligaments, Articular - anatomy & histology Ligaments, Articular - physiology Ligaments, Articular - surgery Medicine Medicine & Public Health Original Article Orthopedics Radiology Radius - anatomy & histology Radius - physiology Range of Motion, Articular - physiology Reconstructive Surgical Procedures Sectioning Skin & tissue grafts Surgery Tendons - anatomy & histology Tendons - physiology Tendons - surgery Translation |
| title | Annular ligament reconstruction with the superficial head of the brachialis: surgical technique and biomechanical evaluation |
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