scholarly journals Ultrasound evaluation shows increase in laxity after partial common extensor origin detachment but not after additional lesion of the radial band of the lateral collateral ligament

2021 ◽  
Author(s):  
Paolo Arrigoni ◽  
Davide Cucchi ◽  
Francesco Luceri ◽  
Andrea Zagarella ◽  
Michele Catapano ◽  
...  
Keyword(s):  
Lateral Collateral Ligament ◽  
Lateral Compartment ◽  
Joint Stability ◽  
Collateral Ligament ◽  
Starting Position ◽  
Additional Lesion ◽  
Anterior Half ◽  
Ultrasound Evaluation ◽  
Linear Probe ◽  
Lateral Elbow

Abstract Purpose The lateral elbow musculature conveys a dynamic valgus moment to the elbow, increasing joint stability. Muscular or tendinous lesions to the anterior half of the common extensor origin (CEO) may provoke a deficiency in the elbow dynamic stabilizers, regardless of their traumatic, degenerative, or iatrogenic aetiology. Furthermore, a role for the radial band of the lateral collateral ligament (R-LCL) has been postulated in the aetiology of lateral elbow pain. This study aimed to evaluate the effects of sequential lateral releases with dynamic ultrasound, evaluating its capability to detect lesions of the CEO and of the R-LCL. Methods Ultrasound investigation of the lateral compartment of the elbow was performed on nine cadaveric specimens with a 10 MHz linear probe in basal conditions, after the release of the anterior half of the CEO and after complete R-LCL release. The lateral joint line widening (λ) was the primary outcome parameter, measured as the linear distance between the humeral and radial articular surfaces. Results The release of the anterior half of the CEO significantly increased λ by 200% compared to the starting position (p = 0.0008) and the previously loaded position (p = 0.0015). Conversely, further release of the R-LCL caused only a marginal, non-significant increase in λ. Conclusions Ultrasound evaluation can detect changes related to tendon tears or muscular avulsions of the CEO and can depict lateral elbow compartmental patholaxity by assessing articular space widening while scanning under dynamic stress. However, it cannot reliably define if the R-LCL is injured. Iatrogenic damage to the CEO should be carefully avoided, since it causes a massive increase in compartmental laxity.

Biomechanical Properties of the Stifle Joint Lateral Collateral Ligament in Dogs

1992 ◽  
Vol 05 (04) ◽  
pp. 158-162 ◽  
Author(s):  
D. Blackketter ◽  
J Harari ◽  
J. Dupuis
Keyword(s):  
Mechanical Properties ◽  
Cruciate Ligament ◽  
Lateral Collateral Ligament ◽  
Biomechanical Properties ◽  
Fibular Head ◽  
Joint Stability ◽  
Collateral Ligament ◽  
Cranial Cruciate Ligament ◽  
Stifle Joint

Bone/lateral collateral ligament/bone preparations were tested and structural mechanical properties compared to properties of cranial cruciate ligament in 15 dogs. The lateral collateral ligament has sufficient stiffness to provide stifle joint stability and strength to resist acute overload following fibular head transposition.

Surgical management of traumatic elbow luxation in two cats using circumferential suture prostheses

2009 ◽  
Vol 22 (01) ◽  
pp. 66-69 ◽  
Author(s):  
D. G. Thomson ◽  
S. Carmichael ◽  
M. Farrell
Keyword(s):  
Postoperative Complications ◽  
Range Of Motion ◽  
Surgical Management ◽  
Lateral Collateral Ligament ◽  
The Other ◽  
Collateral Ligament ◽  
Elbow Luxation ◽  
Lateral Elbow

SummaryTwo Domestic Shorthaired cats were admitted after sustaining a traumatic lateral elbow luxation. Non-surgical management with reduction and external coaptation was unsuccessful at maintaining reduction. At surgery, the lateral collateral ligament (LCL) was intact but grossly elongated in one case, and ruptured in the other. Trans-condylar, trans-radial and trans-ulnar tunnels were drilled from lateral to medial and a suture prosthesis was used in order to augment a suture imbrication of the LCL in the fist cat. The prosthesis was used as a stand-alone procedure in the second case. No postoperative complications occurred and both patients regained excellent elbow range of motion without any observable lameness.

Lateral Elbow Laxity Is Affected by the Integrity of the Radial Band of the Lateral Collateral Ligament Complex: A Cadaveric Model With Sequential Releases and Varus Stress Simulating Everyday Activities

2021 ◽  
pp. 036354652110182
Author(s):  
Paolo Arrigoni ◽  
Davide Cucchi ◽  
Francesco Luceri ◽  
Alessandra Menon ◽  
Carlo Zaolino ◽  
...  
Keyword(s):  
Lateral Collateral Ligament ◽  
Soft Tissue Release ◽  
Stress Tests ◽  
Joint Stability ◽  
Additional Increase ◽  
Intact Specimen ◽  
Biomechanical Models ◽  
Everyday Activities ◽  
Custom Made ◽  
Lateral Elbow

Background: An elongation of the radial lateral collateral complex (R-LCL) can provoke symptomatic minor instability of the lateral elbow leading to lateral elbow pain. Biomechanical models investigating the effects of elongation and partial or complete lesions of the R-LCL on lateral elbow stability are lacking. Purpose: To evaluate how partial and complete R-LCL release affects radiocapitellar joint stability in a setting of controlled varus load and progressive soft tissue release. Study Design: Controlled laboratory study. Methods: Ten fresh-frozen cadaveric specimens were obtained and mounted on a custom-made support to control elbow flexion and extension and to allow for controlled varus loading. Stress tests were performed on all intact specimens under gravity load alone, a 0.5-kg load applied to the hand, and a 1-kg load applied to the hand. After load application, anteroposterior radiographs were obtained. The following release sequence was applied to all specimens: release of the anterior half of the common extensor origin, pie crusting of the R-LCL, and R-LCL release. After each release, stress tests and radiographs were performed. The varus joint angulation of the elbow (α) was measured by 2 examiners as the main outcome parameter. Results: Significant changes in α from the initial condition occurred after each release, and a significant effect of varus load on α was documented for all release steps. A significant effect of the releases on α could be documented for all identical varus load conditions. A linear regression model was generated to describe the effect of varus load on α. Conclusion: Varus loads simulating everyday activities produce changes in the varus joint angulation of the elbow already in the intact specimen, which are linearly dependent on the applied moment and persist after release of the lateral stabilizing structures. With progressive load, a pie crusting of the R-LCL is the minimal procedure able to provoke a significant change in the varus joint angulation, and a complete R-LCL release produces additional increase in the varus joint angulation in all testing conditions. Clinical Relevance: These findings confirm the role of the R-LCL as static lateral stabilizer, supporting a pathological model based on its insufficiency and culminating with a symptomatic minor instability of the lateral elbow.

scholarly journals The relationship between chondromalacia patella, medial meniscal tear and medial periarticular bursitis in patients with osteoarthritis

2017 ◽  
Vol 51 (4) ◽  
pp. 401-406 ◽  
Author(s):  
Mustafa Resorlu ◽  
Davut Doner ◽  
Ozan Karatag ◽  
Canan Akgun Toprak
Keyword(s):  
Medial Meniscus ◽  
Meniscal Tear ◽  
Lateral Collateral Ligament ◽  
Lateral Compartment ◽  
Medial Compartment ◽  
Meniscus Tear ◽  
Collateral Ligament ◽  
Medial Meniscal Tear ◽  
Chondromalacia Patella ◽  
Grade Iii

Abstract Background This study investigated the presence of bursitis in the medial compartment of the knee (pes anserine, semimembranosus-tibial collateral ligament, and medial collateral ligament bursa) in osteoarthritis, chondromalacia patella and medial meniscal tears. Patients and methods Radiological findings of 100 patients undergoing magnetic resonance imaging with a preliminary diagnosis of knee pain were retrospectively evaluated by two radiologists. The first radiologist assessed all patients in terms of osteoarthritis, chondromalacia patella and medial meniscal tear. The second radiologist was blinded to these results and assessed the presence of bursitis in all patients. Results Mild osteoarthritis (grade I and II) was determined in 55 patients and severe osteoarthritis (grade III and IV) in 45 cases. At retropatellar cartilage evaluation, 25 patients were assessed as normal, while 29 patients were diagnosed with mild chondromalacia patella (grade I and II) and 46 with severe chondromalacia patella (grade III and IV). Medial meniscus tear was determined in 51 patients. Severe osteoarthritis and chondromalacia patella were positively correlated with meniscal tear (p < 0.001 and p = 0.018, respectively). Significant correlation was observed between medial meniscal tear and bursitis in the medial compartment (p = 0.038). Presence of medial periarticular bursitis was positively correlated with severity of osteoarthritis but exhibited no correlation with chondromalacia patella (p = 0.023 and p = 0.479, respectively). Evaluation of lateral compartment bursae revealed lateral collateral ligament bursitis in 2 patients and iliotibial bursitis in 5 patients. Conclusions We observed a greater prevalence of bursitis in the medial compartment of the knee in patients with severe osteoarthritis and medial meniscus tear.

scholarly journals Repair of a Divergent Elbow Dislocation with Distal Ulnar Fracture in a Dog Using TightRope and External Skeletal Fixation

VCOT Open ◽  
2021 ◽  
Vol 04 (01) ◽  
pp. e58-e64
Author(s):  
Marcos Garcia ◽  
Camille Bismuth ◽  
Claire Deroy-Bordenave
Keyword(s):  
Elbow Dislocation ◽  
Lateral Collateral Ligament ◽  
Normal Activity ◽  
Long Term Results ◽  
Collateral Ligament ◽  
Elbow Luxation ◽  
Ulnar Fracture ◽  
Fixation System

AbstractThe aim of this study was to report the outcome in a 6-year-old male English Setter dog that suffered a combination of divergent elbow dislocation and open distal ulnar fracture. This study is a case report. After surgical reduction in the elbow luxation, the dog was treated with the TightRope fixation system used as replacement of the lateral collateral ligament, a radioulnar positional screw, and external skeletal fixation. Removal of all implants was performed 3 months postoperatively. The 6-month follow-up visit found the dog without lameness, displaying normal activity, and with normal elbow range of motion and normal Campbell's test. Successful surgical management was achieved with good long-term results using TightRope, a positional screw, and an external skeletal fixator.

scholarly journals Surgical Treatment for Malunion of the Lateral Humeral Epicondyle with Posterior Subluxation of the Radial Head: A Case Report and Literature Review

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Koichi Yano ◽  
Yasunori Kaneshiro ◽  
Hideki Sakanaka
Keyword(s):  
Lateral Collateral Ligament ◽  
High Energy ◽  
Limited Range ◽  
Forearm Rotation ◽  
Collateral Ligament ◽  
Lateral Epicondyle ◽  
Limited Range Of Motion ◽  
Contracture Release ◽  
Normal Congruence ◽  
The Right

A 24-year-old right-handed man suffered right olecranon and lateral epicondylar fracture from high energy trauma. Fixation of olecranon was performed by a previous doctor. Three months after operation, he presented with limited range of motion (ROM) of the right elbow caused by malunion of the lateral epicondylar fracture and subluxation of the radiohumeral joint. Preoperative ROM of the right elbow was flexion 110° and extension −75°. Forearm rotation was pronation 85° and supination 65°. Fragment excision of the lateral epicondyle, which was 27 mm in length, and lateral collateral ligament repair using anchors were performed. Fourteen months postoperatively, contracture release of the elbow was performed. Twenty-four months postoperatively, radiograph of the elbow showed normal congruence without osteoarthritic changes and the ROM of the right elbow was flexion 120° and extension −35°. Forearm rotation was pronation 90° and supination 70°. In the surgical setting, in case of the size of the lateral epicondylar fragment is relatively large, the fragment should be fixed or lateral collateral ligament should be repaired when the instability of the elbow is found.

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