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Abstract
BackgroundAccurate measurement of forces through the proximal radius can assess the effects of some surgical procedures on radioulnar load sharing, but is difficult to achieve given the redundant loading nature of the musculoskeletal system. Previously reported devices have relied on indirect measurements that may alter articular joint location and function. An axial load transducer interposed in the diaphysis of the radius may accurately quantify unknown axial loads of the proximal radius, and maintain articular location.MethodsAn in-vitro radius model was developed by interposing an axial load transducer in the diaphysis of the proximal radius. Static loads of 20, 40, 60, 80, and 100 N were applied with a servo-hydraulic actuator to the native radial head at angles of 10°, 20°, 30°, and 40° in the anterior, posterior, medial and lateral directions.FindingsLinear regression of five repeatability trials showed excellent agreement between the transducer and applied loads (R2 = 1 for all trials). For off-axis net joint loads, the majority of measured loading errors were within the inter-quartile range for mean loads up to 80 N. Loads below 80 N and outside the inter-quartile range had errors of less than 1 N.ConclusionsThe repeatability and off-axis net joint load results of this study validate the effectiveness of the interposed axial load transducer to accurately quantify proximal radius loads. The surgical technique preserves the native articular location and soft-tissue constructs, like the annular ligament. The modular design allows for testing the effects of length-changing osteotomies in subsequent biomechanical studies.
Highlights
Load-sharing between the radius and ulna can be altered by some orthopaedic procedures as a result of implant placement during total elbow arthroplasty, replacement of the radial head with a prosthesis, or radial head and capitellum surgery (Markolf et al 1998)
Accurate measurement of forces through the proximal radius can assess the effects of some surgical procedures on radioulnar load sharing, but is difficult to achieve given the redundant loading nature of the musculoskeletal system
For off-axis net joint loads, the majority of measured loading errors were within the inter-quartile range for mean loads up to 80 N
Summary
Load-sharing between the radius and ulna can be altered by some orthopaedic procedures as a result of implant placement during total elbow arthroplasty, replacement of the radial head with a prosthesis, or radial head and capitellum surgery (Markolf et al 1998). Multiple studies have assessed elbow load sharing, and describe devices capable of measuring in-vitro radial and ulnar loads (Ekenstam et al 1984; Markolf et al 1998; Palmer et al 1984; Palmer and Werner 1981; Pfaeffle and Fischer 1999; Rabinowitz and Light 1994; Trumble and Glisson 1987); these devices disrupt soft tissues, especially the annular ligament, which are significant contributors to the net load vector through the radial head. Such a device which does not disrupt soft tissues, or alter the native location of the radial head, has yet to be described. An axial load transducer interposed in the diaphysis of the radius may accurately quantify unknown axial loads of the proximal radius, and maintain articular location
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