Development of an active elbow flexion simulator to evaluate joint kinematics with the humerus in the horizontal position

Ferreira, Louis M.; Johnson, James A.; King, Graham J.W.

Affiliations

¹Bioengineering Research Laboratory, The Hand and Upper Limb Center, St. Joseph’s Health Care London, 268 Grosvenor Street, London, Ontario, Canada N6A 4L6

²Department of Surgery, The University of Western Ontario, London, Ontario, Canada

³Mechanical and Materials Engineering, The University of Western Ontario, London, Ontario, Canada

⁴Medical Biophysics, The University of Western Ontario, London, Ontario, Canad

Abstract

In-vitro simulation of active joint motion is useful to evaluate rehabilitation protocols and surgical procedures in the laboratory prior to their application in patients. To date, simulated active elbow flexion has been reliably achieved and well established only in the dependent position (humerus vertical with hand down). We have developed and evaluated the performance of a new elbow motion simulator capable of active flexion in the dependent, varus, valgus and horizontal positions. Muscle loading and motion control were achieved via a combination of motors and actuators attached to relevant tendons. Simulated active flexion was compared to passive flexion in terms of repeatability, motion pathways and joint laxity. The joint kinematics of active flexion were significantly more repeatable than passive flexion (p<0.05). Active flexion reduced varus–valgus joint laxity by 29% (supinated p<0.05) and 26% (pronated p<0.05) compared to passive flexion. Greater repeatability of simulated active flexion suggests that this mode of in-vitro testing should increase statistical power and decrease required sample sizes.

Links

DOI: 10.1016/j.jbiomech.2010.04.007

PubMed: 20434158

WoS: 000281534000010

History

Accepted: 2010-04-2

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Cited By (12)

Year	Entry
2022	Anderson DA. In Vitro Investigation of Carpal Tunnel Volume and Morphology Changes With Non-Neutral Wrist Postures [PhD thesis]. University of Guelph; September 2022.
2011	Ferreira LM. Development of an Active Elbow Motion Simulator and Coordinate Systems to Evaluate Kinematics in Multiple Positions [PhD thesis]. University of Western Ontario; 2011.
2012	Lalone EA. An Image-Based Tool to Examine Joint Congruency At the Elbow [PhD thesis]. University of Western Ontario; 2012.
2014	Alolabi B. The Repair, Reconstruction and Replacement of the Coronoid Process [Master's thesis]. University of Western Ontario; 2014.
2014	Desai SJ. Distal Humerus Hemiarthroplasty: Joint Kinematics, Stability, Congruency and Implant Design [Master's thesis]. University of Western Ontario; 2014.
2014	Giles JW. Development of an in-Vitro Passive and Active Motion Simulator for the Investigation of Shoulder Function and Kinematics [PhD thesis]. University of Western Ontario; 2014.
2016	Manocha RHK. Optimizing the Rehabilitation of Elbow Lateral Collateral Ligament Injuries [Master's thesis]. University of Western Ontario; 2016.
2018	Banayan SM. The Kinematic and Biomechanical Effects of Bracing on the Rehabilitation of the LCL Injured Elbow [Master's thesis]. University of Western Ontario; 2018.
2019	Badre A. Radial Head Stability in Anterior Monteggia Injuries: An in Vitro Biomechanical Study [Master's thesis]. University of Western Ontario; 2019.
2020	Berkmortel C. Lower Stiffness Orthopaedic Implants for Hemiarthroplasty [Master's thesis]. University of Western Ontario; 2020.
2021	Kusins J. A Multi-Level Mechanical Assessment of the Shoulder Coupled With Evaluation of Upper Extremity Predictive Finite Element Models [PhD thesis]. University of Western Ontario; 2021.
2024	Vannitamby KD. Optimizing the Management of Anterior Monteggia Fractures: A Biomechanical Evaluation of Treatment Options [Master's thesis]. University of Western Ontario; 2024.