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Evaluation of a computational model to predict elbow range of motion.

Willing RT, Nishiwaki M, Johnson JA, King GJ, Athwal GS - Comput. Aided Surg. (2014)

Bottom Line: 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.

View Article: PubMed Central - PubMed

Affiliation: Bioengineering Research Laboratory, The Hand and Upper Limb Centre, Lawson Health Research Institute, St. Joseph's Health Care London , London , Ontario .

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.

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Related in: MedlinePlus

Illustration of non-physiologic subluxation of the ulnohumeral joint during flexion motions with simulated osteophytes attached. The deviation of the GSN from the FE axis is small at initial impingement when the physiologic flexion limit is met, but increases as the flexion angle is increased further. While this pathologic flexion motion occurs, the joint is hinging about the impingement point on the osteophyte, rather than the FE axis.
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f4: Illustration of non-physiologic subluxation of the ulnohumeral joint during flexion motions with simulated osteophytes attached. The deviation of the GSN from the FE axis is small at initial impingement when the physiologic flexion limit is met, but increases as the flexion angle is increased further. While this pathologic flexion motion occurs, the joint is hinging about the impingement point on the osteophyte, rather than the FE axis.

Mentions: After implanting the simulated osteophytes, the average range of motion before bony impingement was 38 ± 1° in extension and 119 ± 2° in flexion. Again, the deviation of the GSN from the FE axis followed a pattern similar to that for the intact joint for a portion of the flexion-extension ROM; however, the deviation increased sharply at approximately 54° during extension and 102° during flexion, indicating non-physiological subluxation and that the physiologic ROM had been met. Non-physiologic subluxation was confirmed visually by reconstructing the bone positions at the physiologic and pathologic full flexion angles during the osteophyte experiments (Figure 4).Figure 4.


Evaluation of a computational model to predict elbow range of motion.

Willing RT, Nishiwaki M, Johnson JA, King GJ, Athwal GS - Comput. Aided Surg. (2014)

Illustration of non-physiologic subluxation of the ulnohumeral joint during flexion motions with simulated osteophytes attached. The deviation of the GSN from the FE axis is small at initial impingement when the physiologic flexion limit is met, but increases as the flexion angle is increased further. While this pathologic flexion motion occurs, the joint is hinging about the impingement point on the osteophyte, rather than the FE axis.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4269151&req=5

f4: Illustration of non-physiologic subluxation of the ulnohumeral joint during flexion motions with simulated osteophytes attached. The deviation of the GSN from the FE axis is small at initial impingement when the physiologic flexion limit is met, but increases as the flexion angle is increased further. While this pathologic flexion motion occurs, the joint is hinging about the impingement point on the osteophyte, rather than the FE axis.
Mentions: After implanting the simulated osteophytes, the average range of motion before bony impingement was 38 ± 1° in extension and 119 ± 2° in flexion. Again, the deviation of the GSN from the FE axis followed a pattern similar to that for the intact joint for a portion of the flexion-extension ROM; however, the deviation increased sharply at approximately 54° during extension and 102° during flexion, indicating non-physiological subluxation and that the physiologic ROM had been met. Non-physiologic subluxation was confirmed visually by reconstructing the bone positions at the physiologic and pathologic full flexion angles during the osteophyte experiments (Figure 4).Figure 4.

Bottom Line: 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.

View Article: PubMed Central - PubMed

Affiliation: Bioengineering Research Laboratory, The Hand and Upper Limb Centre, Lawson Health Research Institute, St. Joseph's Health Care London , London , Ontario .

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.

Show MeSH
Related in: MedlinePlus