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. 2023 Jan 18;24(1):42.
doi: 10.1186/s12891-023-06149-8.

Elbow joint biomechanics during ADL focusing on total elbow arthroplasty - a scoping review

Daniëlle Meijering  1 , Roos Ga Duijn  2 , Alessio Murgia  2 , Alexander L Boerboom  3 , Denise Eygendaal  4 , Michel Pj van den Bekerom  5   6 , Sjoerd K Bulstra  3 , Martin Stevens  3 , Riemer Jk Vegter  2
Affiliations

Elbow joint biomechanics during ADL focusing on total elbow arthroplasty - a scoping review

Daniëlle Meijering et al. BMC Musculoskelet Disord. .

Abstract

Background: Overloading is hypothesized to be one of the failure mechanisms following total elbow arthroplasty (TEA). It is unclear whether the current post-operative loading instruction is compliant with reported failure mechanisms. Aim is therefore to evaluate the elbow joint load during activities of daily living (ADL) and compare these loads with reported failure limits from retrieval and finite element studies.

Methods: A scoping review of studies until 23 November 2021 investigating elbow joint load during ADL were identified by searching PubMed/Medline and Web of Science. Studies were eligible when: (1) reporting on the elbow joint load in native elbows or elbows with an elbow arthroplasty in adults; (2) full-text article was available.

Results: Twenty-eight studies with a total of 256 participants were included. Methodological quality was low in 3, moderate in 22 and high in 3 studies. Studies were categorized as 1) close to the body and 2) further away from the body. Tasks were then subdivided into: 1) cyclic flexion/extension, 2) push-up, 3) reaching, 4) self-care, 5) work. Mean flexion-extension joint load was 17 Nm, mean varus-valgus joint load 9 Nm, mean pronation-supination joint load 8 Nm and mean bone-on-bone contact force 337 N.

Conclusion: The results of our scoping review give a first overview of the current knowledge on elbow joint loads during ADL. Surprisingly, the current literature is not sufficient to formulate a postoperative instruction for elbow joint loading, which is compliant with failure limits of the prosthesis. In addition, our current instruction does not appear to be evidence-based. Our recommendations offer a starting point to assist clinicians in providing informed decisions about post-operative instructions for their patients.

Keywords: Activities of daily living; Arthroplasty; Biomechanical analysis; Elbow joint loading; Elbow prosthesis.

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Conflict of interest statement

The authors declare they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Steps to analyze joint torque. θelbow = elbow joint angle, τelbow = net joint torque, delbow= moment arm (distance between force vector and rotation point (the elbow axis), Fg = gravitational force (m∗g) and FBone-on-bone = internal bone-on-bone contact force
Fig. 2
Fig. 2
Flow-chart
Fig. 3
Fig. 3
Average net joint moment (flexion–extension), classified per type of task
See this image and copyright information in PMC

References

    1. report LA. LROI Annual report, elbow arthroplasty 2021 [
    1. Welsink CL, Lambers KTA, van Deurzen DFP, Eygendaal D, van den Bekerom MPJ. Total elbow arthroplasty: a systematic review. JBJS Rev. 2017;5(7):e4. doi: 10.2106/JBJS.RVW.16.00089. - DOI - PubMed
    1. Prkic A, Welsink C, The B, van den Bekerom MPJ, Eygendaal D. Why does total elbow arthroplasty fail today? A systematic review of recent literature. Arch Orthop Trauma Surg. 2017;137(6):761–769. doi: 10.1007/s00402-017-2687-x. - DOI - PubMed
    1. Voloshin I, Schippert DW, Kakar S, Kaye EK, Morrey BF. Complications of total elbow replacement: a systematic review. J Shoulder Elbow Surg. 2011;20(1):158–168. doi: 10.1016/j.jse.2010.08.026. - DOI - PubMed
    1. Evans JT, Walker RW, Evans JP, Blom AW, Sayers A, Whitehouse MR. How long does a knee replacement last? A systematic review and meta-analysis of case series and national registry reports with more than 15 years of follow-up. Lancet. 2019;393(10172):655–663. doi: 10.1016/S0140-6736(18)32531-5. - DOI - PMC - PubMed

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