BIOMECHANICAL STUDY ON RECONSTRUCTED ANTERIOR BUNDLE OF ELBOW MEDIAL COLLATERAL LIGAMENT_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

ZHANG Junwei ¹ , GAO Shijun ² , YANG Xinming ¹ , YANG Jing ¹

1Department of Joint Surgery, the First Affiliated Hospital of Hebei North University, Zhangjiakou Hebei, 075000, P.R.China;;
2Department of Joint Surgery, the Third Hospital of Hebei Medical University. Corresponding author: ZHANG Junwei, E-mail: junwei0909@yahoo.com.cn;

Corresponding author：

Keywords：

Elbow valgus stability; Medial collateral ligament; Anterior bundle; Biomechanics; Valgus laxity

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Objective To investigate the effect of complete anterior bundle of medial collateral ligament (MCL) on the valgus stability of the elbow after reconstruction and to assess the efficacy of artificial tendon and interference screw in reconstruction the anterior bundle of MCL. Methods The bone-tendon of the elbow were made in 12 adult upper limb specimens. There were 8 males and 4 females, left side and right side in half. Using biomechanic ways and pressure sensitive film, the valgus laxity, the stress area of the humeroulnar joint, and the intra-articular pressure were measured in integrated anterior bundle of MCL (control group, n=12) and reconstructed anterior bundle of MCL with artificial tendon and interference screw (experimental group, n=12) in elbow flexion of 0, 30, 60, and 90°. Results There was no significant difference in the valgus laxity within group and between groups in different flexion degrees (P gt; 0.05). No significant difference was found in the intra-articular pressure in elbow flexion of 30, 60, and 90° within group and between groups (P gt; 0.05) except in elbow flexion of 0° (P lt; 0.05). The stress area of the humeroulnar joint in 0° flexion was significantly larger than that in 30, 60, and 90° flexion in the control group (P lt; 0.05), but no significant difference was found within group and between groups in the other flexion degrees (P gt; 0.05). Conclusion The anterior bundle of MCL has important significance for maintaining the valgus stability of the elbow, after reconstructing the anterior bundle by using artificial tendon and interference screw, the medial stability of elbow can be recovered immediately.

Citation： ZHANG Junwei,GAO Shijun,YANG Xinming,YANG Jing. BIOMECHANICAL STUDY ON RECONSTRUCTED ANTERIOR BUNDLE OF ELBOW MEDIAL COLLATERAL LIGAMENT. Chinese Journal of Reparative and Reconstructive Surgery, 2012, 26(8): 930-933. doi: Copy

1.	王友华, 纪标, 吴菊, 等. 肘关节内侧副韧带生物力学及临床研究. 解剖与临床, 2005, 10(3): 184-186.
2.	蒋涛, 黄富国, 彭加英, 等. 重建肘关节外翻稳定性的生物力学研究. 中国修复重建外科杂志, 2005, 19(2): 141-144.
3.	蒋涛, 黄富国, 徐建华, 等. 肘关节尺侧副韧带的修复重建. 中国修复重建外科杂志, 2008, 22(1): 1-4.
4.	余恒明, 刘娟, 李鑫. 肘关节尺侧副韧带屈曲角度与负荷关系的生物力学研究. 中国矫形外科杂志, 2011, 19(12): 1010-1013.
5.	Osbahr DC, Dines JS, Breazeale NM, et al. Ulnohumeral chondral and ligamentous overload: biomechanical correlation for posteromedial chondromalacia of the elbow in throwing athletes. Am J Sports Med, 2010, 38(12): 2535-2541.
6.	Ahmad CS, Park MC, Elattrache NS. Elbow medial ulnar collateral ligament insufficiency alters posteromedial olecranon contact. Am J Sports Med, 2004, 32(7): 1607-1612.
7.	毛宾尧. 肘关节不稳定. 中国矫形外科杂志, 2000, 7(9): 917-918.
8.	O’Driscoll SW, Jupiter JB, King GJ, et al. The unstable elbow. Instr Course Lect, 2001, 50: 89-102.
9.	陈疾忤, 陈世益. 肘关节不稳的诊治进展. 国外医学: 骨科学分册, 2004, 25(2): 86-89.
10.	Morrey BF, Tanaka S, An KN. Valgus stability of the elbow. A definition of primary and secondary constraints. Clin Orthop Relat Res, 1991, (265): 187-195.
11.	Floris S, Olsen BS, Dalsta M, et al. The medial collateral ligament of the elbow joint: anatomy and kinematics. J Shoulder Elbow Surg, 1998, 7(4): 345-351.
12.	范凌, 潘显明, 权毅, 等. 尺侧副韧带完整性对肘关节稳定性的影响及临床研究. 中国现代医学杂志, 2011, 21(20): 2436-2438, 2441.
13.	陈硕, 黄富国, 钟刚, 等. 尺骨冠突骨折合并内侧副韧带前束损伤致肘关节后外侧旋转不稳定的生物力学研究. 中国修复重建外科杂志, 2010, 24(2): 215-218.
14.	Jobe FW, Stark H, Lombardo SJ. Reconstruction of the ulnar collateral ligament in athletes. J Bone Joint Surg (Am), 1986, 68(8): 1158-1163.
15.	Hechtman KS, Tjin-A-Tsoi EW, Zvijac JE, et al. Biomechanics of a less invasive procedure for reconstruction of the ulnar collateral ligament of the elbow. Am J Sports Med, 1998, 26(5): 620-624.
16.	Langer P, Fadale P, Hulstyn M. Evolution of the treatment options of ulnar collateral ligament injuries of the elbow. Br J Sports Med, 2006, 40(6): 499-506.
17.	McAdams TR, Lee AT, Centeno J, et al. Two ulnar collateral ligament reconstruction methods: the docking technique versus bioabsorbable interference screw fixation—a biomechanical evaluation with cyclic loading. J Shoulder Elbow Surg, 2007, 16(2): 224-228.

1. 王友华, 纪标, 吴菊, 等. 肘关节内侧副韧带生物力学及临床研究. 解剖与临床, 2005, 10(3): 184-186.
2. 蒋涛, 黄富国, 彭加英, 等. 重建肘关节外翻稳定性的生物力学研究. 中国修复重建外科杂志, 2005, 19(2): 141-144.
3. 蒋涛, 黄富国, 徐建华, 等. 肘关节尺侧副韧带的修复重建. 中国修复重建外科杂志, 2008, 22(1): 1-4.
4. 余恒明, 刘娟, 李鑫. 肘关节尺侧副韧带屈曲角度与负荷关系的生物力学研究. 中国矫形外科杂志, 2011, 19(12): 1010-1013.
5. Osbahr DC, Dines JS, Breazeale NM, et al. Ulnohumeral chondral and ligamentous overload: biomechanical correlation for posteromedial chondromalacia of the elbow in throwing athletes. Am J Sports Med, 2010, 38(12): 2535-2541.
6. Ahmad CS, Park MC, Elattrache NS. Elbow medial ulnar collateral ligament insufficiency alters posteromedial olecranon contact. Am J Sports Med, 2004, 32(7): 1607-1612.
7. 毛宾尧. 肘关节不稳定. 中国矫形外科杂志, 2000, 7(9): 917-918.
8. O’Driscoll SW, Jupiter JB, King GJ, et al. The unstable elbow. Instr Course Lect, 2001, 50: 89-102.
9. 陈疾忤, 陈世益. 肘关节不稳的诊治进展. 国外医学: 骨科学分册, 2004, 25(2): 86-89.
10. Morrey BF, Tanaka S, An KN. Valgus stability of the elbow. A definition of primary and secondary constraints. Clin Orthop Relat Res, 1991, (265): 187-195.
11. Floris S, Olsen BS, Dalsta M, et al. The medial collateral ligament of the elbow joint: anatomy and kinematics. J Shoulder Elbow Surg, 1998, 7(4): 345-351.
12. 范凌, 潘显明, 权毅, 等. 尺侧副韧带完整性对肘关节稳定性的影响及临床研究. 中国现代医学杂志, 2011, 21(20): 2436-2438, 2441.
13. 陈硕, 黄富国, 钟刚, 等. 尺骨冠突骨折合并内侧副韧带前束损伤致肘关节后外侧旋转不稳定的生物力学研究. 中国修复重建外科杂志, 2010, 24(2): 215-218.
14. Jobe FW, Stark H, Lombardo SJ. Reconstruction of the ulnar collateral ligament in athletes. J Bone Joint Surg (Am), 1986, 68(8): 1158-1163.
15. Hechtman KS, Tjin-A-Tsoi EW, Zvijac JE, et al. Biomechanics of a less invasive procedure for reconstruction of the ulnar collateral ligament of the elbow. Am J Sports Med, 1998, 26(5): 620-624.
16. Langer P, Fadale P, Hulstyn M. Evolution of the treatment options of ulnar collateral ligament injuries of the elbow. Br J Sports Med, 2006, 40(6): 499-506.
17. McAdams TR, Lee AT, Centeno J, et al. Two ulnar collateral ligament reconstruction methods: the docking technique versus bioabsorbable interference screw fixation—a biomechanical evaluation with cyclic loading. J Shoulder Elbow Surg, 2007, 16(2): 224-228.

Chinese Journal of Reparative and Reconstructive Surgery

BIOMECHANICAL STUDY ON RECONSTRUCTED ANTERIOR BUNDLE OF ELBOW MEDIAL COLLATERAL LIGAMENT

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