Limits...
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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Examination of the simulation-predicted impingement locations. Flexion was limited by impingement of the coronoid process in the coronoid fossa. Extension was limited by impingement of the olecranon in the olecranon fossa.
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f5: Examination of the simulation-predicted impingement locations. Flexion was limited by impingement of the coronoid process in the coronoid fossa. Extension was limited by impingement of the olecranon in the olecranon fossa.

Mentions: The flexion and extension ROM limits for the intact and osteophyte geometries were also calculated using the computational model (0°–161° and 53°–104°, respectively). Using a 10× lower (0.3 Nm) or 10× higher (30 Nm) flexion moment caused the simulation-predicted flexion-extension arc of the intact model to decrease by 0.4° (−0.2%) or increase by 0.3° (0.2%), respectively. Visual inspection of the simulation results confirmed that bone to bone impingement of the coronoid process against the coronoid fossa had occurred at full flexion, while impingement of the olecranon against the olecranon fossa occurred at full extension (Figure 5).Figure 5.


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)

Examination of the simulation-predicted impingement locations. Flexion was limited by impingement of the coronoid process in the coronoid fossa. Extension was limited by impingement of the olecranon in the olecranon fossa.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

f5: Examination of the simulation-predicted impingement locations. Flexion was limited by impingement of the coronoid process in the coronoid fossa. Extension was limited by impingement of the olecranon in the olecranon fossa.
Mentions: The flexion and extension ROM limits for the intact and osteophyte geometries were also calculated using the computational model (0°–161° and 53°–104°, respectively). Using a 10× lower (0.3 Nm) or 10× higher (30 Nm) flexion moment caused the simulation-predicted flexion-extension arc of the intact model to decrease by 0.4° (−0.2%) or increase by 0.3° (0.2%), respectively. Visual inspection of the simulation results confirmed that bone to bone impingement of the coronoid process against the coronoid fossa had occurred at full flexion, while impingement of the olecranon against the olecranon fossa occurred at full extension (Figure 5).Figure 5.

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