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Elbow joint biomechanics for preclinical evaluation of total elbow prostheses

机译：肘关节生物力学用于全肘关节假体的临床前评估

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摘要

Total elbow arthroplasty is a clinically successful procedure, yet long-term implant survival rates have historically lagged behind those reported for total hips and knees. Clinical complications associated with implant wear, osteolysis, stem loosening and device fracture have been implicated as reasons for limited long-term survivorship. Unfortunately, there is little published information on the biomechanics and method(s) for preclinical evaluation of total elbow prostheses that could provide insight into the mechanisms of failure. Additionally, there are no consensus testing standards or summaries of loading profiles of the humero-ulnar joint associated with a range of activities of daily living. Such data would facilitate the standardized preclinical assessment of total elbow devices such is commonplace for other large joints. The objective of the work here is therefore to provide a comprehensive review of elbow joint biomechanics as it relates to preclinical evaluation of total elbow implants. This summary includes a review of elbow joint forces, kinematics, the types and frequency of humero-ulnar joint motions associated with activities of daily living and clinical outcomes, as well as proposing a methodology for deriving humero-ulnar joint reaction force magnitudes and vector orientations as a function of a known mass/force at the hand. From these data, a scalable, bi-axial loading profile is proposed as a foundation for the development of clinically relevant, laboratory simulations for assessment of total elbow prostheses performance.
机译：全肘关节置换术是一种临床上成功的方法，但长期的植入物存活率在历史上一直落后于报告的全髋关节和膝关节的存活率。与植入物磨损，溶骨，茎干松动和器械断裂相关的临床并发症已被认为是长期生存率有限的原因。不幸的是，几乎没有关于生物力学和方法的临床信息，可以对整个肘关节假体进行临床前评估，从而可以了解失败的机理。此外，还没有共识性的测试标准或肱骨-尺骨关节与一系列日常活动相关的负荷曲线摘要。这样的数据将有助于对整个肘部装置进行标准化的临床前评估，这在其他大型关节中很常见。因此，这里的工作目的是对肘关节的生物力学进行全面的综述，因为它涉及整个肘关节植入物的临床前评估。本摘要包括对肘关节力量，运动学，与肱骨活动有关的肱骨-尺骨关节运动的类型和频率以及临床结局的综述，并提出了得出肱骨-尺骨关节反作用力幅度和向量方向的方法取决于手头上已知的质量/力。从这些数据中，提出了可扩展的双轴载荷曲线，作为开发临床相关的实验室模拟以评估整个肘关节假体性能的基础。

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