Abstract
Computer models capable of predicting elbow flexion and extension range of motion (ROM) limits would be useful for assisting surgeons in improving the outcomes of surgical treatment of patients with elbow contractures. A simple and robust computer-based model was developed that predicts elbow joint ROM using bone geometries calculated from computed tomography image data. The model assumes a hinge-like flexion-extension axis, and that elbow passive ROM limits can be based on terminal bony impingement. The model was validated against experimental results with a cadaveric specimen, and was able to predict the flexion and extension limits of the intact joint to 0° and 3°, respectively. The model was also able to predict the flexion and extension limits to 1° and 2°, respectively, when simulated osteophytes were inserted into the joint. Future studies based on this approach will be used for the prediction of elbow flexion-extension ROM in patients with primary osteoarthritis to help identify motion-limiting hypertrophic osteophytes, and will eventually permit real-time computer-assisted navigated excisions.
Highlights
IntroductionTerminal range of motion (ROM) is limited by bone-on-bone impingement due to hypertrophic osteophytes [1, 2]
In primary elbow osteoarthritis, terminal range of motion (ROM) is limited by bone-on-bone impingement due to hypertrophic osteophytes [1, 2]
A simple and robust computer-based model was developed that predicts elbow joint ROM using bone geometries calculated from computed tomography image data
Summary
Terminal range of motion (ROM) is limited by bone-on-bone impingement due to hypertrophic osteophytes [1, 2]. Dynamic assessment of impingement with computer models, derived from CT data, which can simulate the ROM of healthy and arthritic elbows would be useful surgical planning tools. Such models would allow pre-operative assessment of which osteophytes limit ROM, and the anticipated increase in ROM if those osteophytes were to be resected. Such pre-operative planning would allow for more efficient and possibly less invasive surgical treatment, and may lead to the development of newer navigation-assisted debridement techniques [7]. Some models are limited to hinge-like movement [8,9,10,11, 13, 15], while others
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