PubMed · 14503738
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A Seth Greenwald. 2003. Current concepts in joint replacement.. https://doi.org/10.3928/0147-7447-20030901-03
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In the financial year ending June 2002, 26 689 hip replacements and 26089 knee replacements (total, 52778) were performed in Australia. Hip and knee replacement procedures have increased between 5%-10% each year for the past 10 years, with a combined increase in hip and knee replacement of 13.4% in the past year. The revision rate for hip replacement surgery in Australia is unknown but is estimated to be 20%-24%; the revision rate for hip replacement surgery in Sweden is 7%. Although data collection for the Registry is voluntary, it has 100% compliance from hospitals undertaking joint-replacement surgery.
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OBJECTIVE: Aim of this study was to exactly describe and quantify kinematics of the ulna during pro- and supination. DESIGN: Biomechanical study in fresh frozen cadavers. BACKGROUND: A previous MRI study revealed a varus/valgus motion of the ulna averaging 7.1 degrees during pro-/supination. Axial rotation, however, could not be quantified. METHODS: Sixteen arms were examined in a new apparatus that fixed the humerus on a template and allowed forearm rotation. Motion of a Kirschner wire placed in the ulna was recorded in steps of 30 degrees by two perpendicularly arranged charge coupled device cameras during pro- and supination. RESULTS: From supination to pronation the ulna showed a semi-lunar evasive motion in the coronal and transverse plane with an initial varus shift, then a dorsal and finally a valgus shift. Motion in the coronal plane averaged 14.14 degrees (SD 4.78). Valgus angles of the ulna in 30 degrees, 60 degrees and 90 degrees pronation were significant (P<0.05) to each other and the neutral position. Varus angles of the ulna in 30 degrees, 60 degrees and 90 degrees supination (P<0.01) were significant to each other and the neutral position.A maximum ulnar axial pronation rotation of 3.2 degrees (SD 2 degrees ) was noted. Axial rotation angles of 90 degrees and 60 degrees of pronation were significant to each other and to the neutral position (P<0.05), respectively. CONCLUSIONS: To prevent increased stress on the bone-cement interface in elbow arthroplasty, a mean axial rotation of at least 3.2 degrees should be possible.