TY - JOUR
T1 - Elbow Joint Loads during Simulated Activities of Daily Living
T2 - Implications for Formulating Recommendations after Total Elbow Arthroplasty
AU - Duijn, Roos G.A.
AU - Meijering, Daniëlle
AU - Vegter, Riemer J.K.
AU - Albers, Friederike
AU - Boerboom, Alexander L.
AU - Eygendaal, Denise
AU - van den Bekerom, Michel P.J.
AU - Stevens, Martin
AU - Schelhaas, Reslin
AU - Lamoth, Claudine J.C.
AU - Murgia, Alessio
N1 - Copyright © 2023. Published by Elsevier Inc.
PY - 2024/1
Y1 - 2024/1
N2 - BACKGROUND: Overloading of the elbow joint prosthesis following total elbow arthroplasty can lead to implant failure. Joint moments during daily activities are not well-contextualized for a prosthesis' failure limits and the effect of the current postoperative instruction on elbow joint loading is unclear. This study investigates the difference in elbow joint moments between simulated daily tasks and between flexion-extension, pronation-supination, varus-valgus movement directions. Additionally, the effect of the current postoperative instruction on elbow joint load is examined.METHODS: Nine healthy participants (age 45.8 ± 17 years, 3 males) performed eight tasks; driving a car, opening a door, rising from chair, lifting, sliding, combing hair, drinking, emptying cup, without and with the instruction "not lifting more than 1 kg". Upper limb kinematics and hand contact forces were measured. Elbow joint angles and net moments were analyzed using inverse dynamic analysis, where the net moments are estimated from movement data and external forces.RESULTS: Peak elbow joint moments differed significantly between tasks (p < 0.01) and movement directions (p < 0.01). The most and least demanding tasks were, rising from a chair (13.4 Nm extension, 5.0 Nm supination, 15.2 Nm valgus) and sliding (4.3 Nm flexion, 1.7 Nm supination, 2.6 Nm varus). Net moments were significantly reduced after instruction only in the chair task (p < 0.01).CONCLUSION: This study analyzed elbow joint moments in different directions during daily tasks. The outcomes question whether postoperative instruction can lead to decreasing elbow loads. Future research might focus on reducing elbow loads in the flexion-extension and varus-valgus directions.
AB - BACKGROUND: Overloading of the elbow joint prosthesis following total elbow arthroplasty can lead to implant failure. Joint moments during daily activities are not well-contextualized for a prosthesis' failure limits and the effect of the current postoperative instruction on elbow joint loading is unclear. This study investigates the difference in elbow joint moments between simulated daily tasks and between flexion-extension, pronation-supination, varus-valgus movement directions. Additionally, the effect of the current postoperative instruction on elbow joint load is examined.METHODS: Nine healthy participants (age 45.8 ± 17 years, 3 males) performed eight tasks; driving a car, opening a door, rising from chair, lifting, sliding, combing hair, drinking, emptying cup, without and with the instruction "not lifting more than 1 kg". Upper limb kinematics and hand contact forces were measured. Elbow joint angles and net moments were analyzed using inverse dynamic analysis, where the net moments are estimated from movement data and external forces.RESULTS: Peak elbow joint moments differed significantly between tasks (p < 0.01) and movement directions (p < 0.01). The most and least demanding tasks were, rising from a chair (13.4 Nm extension, 5.0 Nm supination, 15.2 Nm valgus) and sliding (4.3 Nm flexion, 1.7 Nm supination, 2.6 Nm varus). Net moments were significantly reduced after instruction only in the chair task (p < 0.01).CONCLUSION: This study analyzed elbow joint moments in different directions during daily tasks. The outcomes question whether postoperative instruction can lead to decreasing elbow loads. Future research might focus on reducing elbow loads in the flexion-extension and varus-valgus directions.
U2 - 10.1016/j.jse.2023.07.042
DO - 10.1016/j.jse.2023.07.042
M3 - Article
C2 - 37689102
SN - 1058-2746
VL - 33
SP - 145
EP - 155
JO - Journal of Shoulder and Elbow Surgery
JF - Journal of Shoulder and Elbow Surgery
IS - 1
ER -