Rehabilitation of the medial collateral ligament-deficient elbow: An in vitro biomechanical study

2000 ◽  
Vol 25 (6) ◽  
pp. 1051-1057 ◽  
Author(s):  
April D. Armstrong ◽  
Cynthia E. Dunning ◽  
Kenneth J. Faber ◽  
Teresa R. Duck ◽  
James A. Johnson ◽  
...  
Keyword(s):  
Medial Collateral Ligament ◽  
Biomechanical Study ◽  
Collateral Ligament

The Effectiveness of a Hinged Elbow Orthosis in Medial Collateral Ligament Injuries: An In Vitro Biomechanical Study

2019 ◽  
Vol 47 (12) ◽  
pp. 2827-2835
Author(s):  
Ranita H.K. Manocha ◽  
James A. Johnson ◽  
Graham J.W. King
Keyword(s):  
Medial Collateral Ligament ◽  
Muscle Activation ◽  
Mechanical Stability ◽  
Biomechanical Study ◽  
Return To Play ◽  
Collateral Ligament ◽  
Valgus Stress ◽  
Active Motion ◽  
Early Return

Background: Medial collateral ligament (MCL) injuries are common after elbow trauma and in overhead throwing athletes. A hinged elbow orthosis (HEO) is often used to protect the elbow from valgus stress early after injury and during early return to play. However, there is minimal evidence regarding the efficacy of these orthoses in controlling instability and their influence on long-term clinical outcomes. Purpose: (1) To quantify the effect of an HEO on elbow stability after simulated MCL injury. (2) To determine whether arm position, forearm rotation, and muscle activation influence the effectiveness of an HEO. Study Design: Controlled laboratory study. Methods: Seven cadaveric upper extremity specimens were tested in a custom simulator that enabled elbow motion via computer-controlled actuators and motors attached to relevant tendons. Specimens were examined in 2 arm positions (dependent, valgus) and 2 forearm positions (pronation, supination) during passive and simulated active elbow flexion while unbraced and then while braced with an HEO. Testing was performed in intact elbows and repeated after simulated MCL injury. An electromagnetic tracking device measured valgus angulation as an indicator of elbow stability. Results: When the arm was dependent, the HEO increased valgus angle with the forearm in pronation (+1.0°± 0.2°, P = .003) and supination (+1.5°± 0.0°, P = .006) during active motion. It had no significant effect on elbow stability during passive motion. In the valgus position, the HEO had no effect on elbow stability during passive or active motion in pronation and supination. With the arm in the valgus position with the HEO, muscle activation reduced instability during pronation (–10.3°± 2.5°, P = .006) but not supination ( P = .61). Conclusion: In this in vitro study, this HEO did not enhance mechanical stability when the arm was in the valgus and dependent positions after MCL injury. Clinical Relevance: After MCL injury, an HEO likely does not provide mechanical elbow stability during rehabilitative exercises or when the elbow is subjected to valgus stress such as occurs during throwing.

scholarly journals Biomechanical study of the effect of platelet rich plasma on the treatment of medial collateral ligament lesion in rabbits

2017 ◽  
Vol 32 (10) ◽  
pp. 827-835 ◽  
Author(s):  
Eduardo Louzada da Costa ◽  
Luiz Eduardo Moreira Teixeira ◽  
Bruno Jannotti Pádua ◽  
Ivana Duval de Araújo ◽  
Leonardo de Souza Vasconcellos ◽  
...  
Keyword(s):  
Medial Collateral Ligament ◽  
Platelet Rich Plasma ◽  
Biomechanical Study ◽  
Collateral Ligament

Medial Collateral Ligament Strain with Partial Posteromedial Olecranon Resection: A Biomechanical Study

2004 ◽  
Vol 86 (11) ◽  
pp. 2424-2430 ◽  
Author(s):  
Srinath Kamineni ◽  
Neal S. ElAttrache ◽  
Shawn W. OʼDriscoll ◽  
Christopher S. Ahmad ◽  
Hirotsune Hirohara ◽  
...  
Keyword(s):  
Medial Collateral Ligament ◽  
Biomechanical Study ◽  
Collateral Ligament ◽  
Ligament Strain

Lateral Collateral Ligament Repair Restores the Initial Varus Stability of the Elbow: An In Vitro Biomechanical Study

2008 ◽  
Vol 22 (9) ◽  
pp. 615-623 ◽  
Author(s):  
Gillian S Fraser ◽  
Jamie E Pichora ◽  
Louis M Ferreira ◽  
Jamie R Brownhill ◽  
James A Johnson ◽  
...  
Keyword(s):  
Lateral Collateral Ligament ◽  
Biomechanical Study ◽  
Ligament Repair ◽  
Collateral Ligament

Variations in Rupture Site and Surface Strains at Failure in the Maturing Rabbit Medial Collateral Ligament

1995 ◽  
Vol 117 (4) ◽  
pp. 455-461 ◽  
Author(s):  
T. C. Lam ◽  
N. G. Shrive ◽  
C. B. Frank
Keyword(s):  
Medial Collateral Ligament ◽  
Surface Strain ◽  
Collateral Ligament ◽  
Anterior Portion ◽  
Femoral Insertion ◽  
Tibial Insertion ◽  
Medial Side ◽  
Optical Strain Measurement ◽  
Optical Strain

The relationship between the pattern of surface strain and the site of failure in maturing rabbit ligaments was studied in vitro. Bone-medial collateral ligament (MCL)-bone complexes of 24 female New Zealand White rabbits at 3, 6, 9 and 12 months of age (n = 6 rabbits, 12 MCLs per group) were tested in tension to failure. A video dimension analysis (VDA) system was used to map the surface strain at failure across the width and along the length of the medial side of each MCL during testing. Results showed that the highest strains were consistently located at the femoral insertion decreasing towards the midsubstance, with the highest strain occurring in the anterior portion of the MCL immediately adjacent to the femoral insertion. Strains of the complex at failure increased with rabbit maturation. The strain distribution however, did not change dramatically, even though the locations of MCL failure changed from exclusively tibial avulsion in the three month old rabbits to predominantly midsubstance failures in the 12 month old rabbits. In the six month old rabbits, there was a particular dissociation with all MCLs failing near the tibial insertion while femoral strains were apparently the highest. These results suggest two possibilities beyond that of some unknown artifacts of optical strain measurement. First, since failure sites rarely correlated with areas of maximum surface strain in this study, it seems possible that higher strains could exist deeper in the tissue, particularly at the bone-ligament interface of the tibial insertion in immature animals and somewhere within the midsubstance of the MCL in the adult. Secondly, it is possible that the ligament material may be heterogeneous.

Biomechanical Study Using Fuzzy Systems to Quantify Collagen Fiber Recruitment and Predict Creep of the Rabbit Medial Collateral Ligament

2004 ◽  
Vol 127 (3) ◽  
pp. 484-493 ◽  
Author(s):  
A. F. Ali ◽  
M. M. Reda Taha ◽  
G. M. Thornton ◽  
N. G. Shrive ◽  
C. B. Frank
Keyword(s):  
Medial Collateral Ligament ◽  
Collagen Fiber ◽  
Strain Curve ◽  
Biomechanical Study ◽  
Collateral Ligament ◽  
Creep Tests ◽  
Inference System ◽  
Experimental Database ◽  
Creep Stress ◽  
Adaptive Neurofuzzy Inference System

In normal daily activities, ligaments are subjected to repeated loads, and respond to this environment with creep and fatigue. While progressive recruitment of the collagen fibers is responsible for the toe region of the ligament stress-strain curve, recruitment also represents an elegant feature to help ligaments resist creep. The use of artificial intelligence techniques in computational modeling allows a large number of parameters and their interactions to be incorporated beyond the capacity of classical mathematical models. The objective of the work described here is to demonstrate a tool for modeling creep of the rabbit medial collateral ligament that can incorporate the different parameters while quantifying the effect of collagen fiber recruitment during creep. An intelligent algorithm was developed to predict ligament creep. The modeling is performed in two steps: first, the ill-defined fiber recruitment is quantified using the fuzzy logic. Second, this fiber recruitment is incorporated along with creep stress and creep time to model creep using an adaptive neurofuzzy inference system. The model was trained and tested using an experimental database including creep tests and crimp image analysis. The model confirms that quantification of fiber recruitment is important for accurate prediction of ligament creep behavior at physiological loads.

Characterization of the intrinsic properties of the anterior cruciate and medial collateral ligament cells: An in vitro cell culture study

1992 ◽  
Vol 10 (4) ◽  
pp. 465-475 ◽  
Author(s):  
Chandrasekharam N. Nagineni ◽  
David Amiel ◽  
Melvin H. Green ◽  
Matthew Berchuck ◽  
Wayne H. Akeson
Keyword(s):  
Cell Culture ◽  
Medial Collateral Ligament ◽  
Intrinsic Properties ◽  
Collateral Ligament ◽  
Culture Study ◽  
Cell Culture Study ◽  
In Vitro Cell Culture ◽  
Anterior Cruciate
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