Biomechanical study on the reconstruction of anterior bundle of ulnar collateral ligament of elbow joint using suture anchor combined with bone tunnel technique
CAI Hui,XU Shi-ming,DENG Zi-wen,HUANG Dong,LIU Xiao-chun,YU Chao-qun
Chinese Journal of Clinical Anatomy ›› 2018, Vol. 36 ›› Issue (3) : 319-324.
Biomechanical study on the reconstruction of anterior bundle of ulnar collateral ligament of elbow joint using suture anchor combined with bone tunnel technique
Objective To explore the valgus stability of the elbow joint when the anterior bundle of ulnar collateral ligament (UCL) in three states of complete, fracture and reconstruction, and to evaluate the effectiveness of suture anchor combined with bone tunnel technique. Methods 8 fresh adult upper limb cadavers were adopted to establish samples of the bone-ligament of the elbow joint, and the anterior bundle of UCL of each sample was simulated as three states of intact, fracture and reconstruction, then the biomechanical indexes of the elbow joint at 0°, 30°, 60°, 90°and 120°, including valgus laxity, contact area and pressure in the humeroradial joint. The samples were divided into 3 groups according to the different state of the anterior bundle of UCL: the intact group, the fracture group, and the reconstruction group. There were 8 cases in every group. The data were obtained and statistic analysis was made. Results In each group, the biomechanical indexes of each group at 0° were significantly different when those under (P＜0.05）； among the three groups，there was no statistical difference in the biomechanical indexes of each group at 0 °（P＞0.05）, whereas significant difference would be found at the other angles between the intact and fracture groups and the fracture and reconstruction groups（P＜0.05）. Conclusion The anterior bundle of UCL is an important structure to maintain the valgus stability of the elbow joint. The elbow joint at the straight position is relatively stable compared with the flexion position. The elbow joint after reconstruction of anterior bundle of UCL using suture anchor combined with bone tunnel technique not only has sufficient stability, but also has the same excellent biomechanical properties as the normal elbow.
Elbow joint / Ulnar collateral ligament / Reconstruction / Biomechanics
[1] Erickson BJ, Harris JD, Chalmers PN, et al. Ulnar collateral ligament reconstruction: anatomy, indications, techniques, and outcomes[J]. Sports Health, 2015, 7(6): 511-517.
[2] Savoie FH, O'BRien M. Chronic medial instability of the elbow[J]. EFORT Open Rev, 2017, 2(1): 1-6.
[3] Daruwalla JH, Daly CA, Seiler JG 3rd. Medial elbow injuries in the throwing athlete[J]. Hand Clin, 2017, 33(1): 47-62.
[4] Dugas J, Chronister J, Cain EL Jr, et al. Ulnar collateral ligament in the overhead athlete: a current review[J]. Sports Med Arthrosc Rev, 2014, 22(3): 169-182.
[5] 崔岩,潘昭勋,张洪鑫,等.前束等长重建肘关节内侧副韧带的临床效果[J]. 实用医药杂志, 2013, 30(5): 419-421.
[6] Camp CL, Dines JS, Voleti PB, et al. Ulnar collateral ligament reconstruction of the elbow: The docking technique[J]. Arthrosc Tech, 2016, 5(3): e519- e523.
[7] 王友华,汤锦波,纪标,等.肘关节内侧副韧带形态结构研究[J]. 中国临床医学, 2005, 12(1): 115-117.
[8] 杨运平, 徐达传, 赵卫东, 等. 肘关节稳定性的应用解剖和生物力学研究[J]. 中国临床解剖学杂志, 2002, 20(4): 243-245.
[9] 纪标, 王友华, 赵敦炎, 等. 肘关节内侧副韧带的解剖、功能及生物力学的研究[J]. 南通大学学报（医学版）, 2006, 26(2): 97-99.
[10]Lynch JL, Maerz T, Kurdziel MD, et al. Biomechanical evaluation of the tightRope versus traditional docking ulnar collateral ligament reconstruction technique : kinematic and failure testing[J]. AM J Sports Med, 2013, 41(5): 1165-1173.
[11]Cohen SB, Woods DP, Siegler S, et al. Biomechanical comparison of graft fixation at 30° and 90° of elbow flexion for ulnar collateral ligament reconstruction by the docking technique[J]. J Shoulder Elbow Surg, 2015, 24(2): 265-272.
[12]Erickson BJ, Bach BR Jr, Cohen MS, et al. Ulnar collateral ligament reconstruction : The rush experience[J]. Orthop J Sports Med, 2016, 4(1): 2325967115626876.
[13]Erickson BJ, Cvetanovich GL, Frank RM, et al. Do clinical results and return-to-sport rates after ulnar collateral ligament reconstruction differ based on graft choice and surgical technique[J]. Orthop J Sports Med, 2016, 4(11): 2325967116670142.
[14]张军威. 肘关节内侧副韧带前束损伤与肘外翻不稳定[J]. 中国运动医学杂志, 2012, 31(9): 830-834.
[15]Chronister JE, Morris RP, Andersen CR, et al. A biomechanical comparison of 2 hybrid techniques for elbow ulnar collateral ligament reconstruction[J]. J Hand Surg AM, 2014, 39(10): 2033-2040.
[16]Wong TT, Lin DJ, Ayyala RS, et al. Elbow injuries in adult overhead athletes[J]. AJR Am J Roentgenol, 2017, 208(3): W110-W120.
[17]Leahy I, Schorpion M, Ganley T. Common medial elbow injuries in the adolescent athlete[J]. J Hand Ther, 2015, 28(2): 201-210.
[18]林艳红,林木南,李西海,等.生物力学调节骨关节炎软骨退变的作用机制探讨[J]. 风湿病与关节炎, 2014,3(9): 54-56.
[19]Kaplan DJ, Glait SA, Ryan WE Jr, et al. Modified Jobe approach with docking technique for ulnar collateral ligament reconstruction[J]. Arthrosc Tech, 2016, 5(6): e1321-e1326.
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