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Osteoarthritis and cartilage v.26 no.1, 2018년, pp.72 - 83   SCI SCIE
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Altered bone density and stress distribution patterns in long-standing cubitus varus deformity and their effect during early osteoarthritis of the elbow

Miyamura, S.    (Department of Orthopaedic Surgery, Osaka University, Graduate School of Medicine, 2-2 Yamada-oka, Suita, Osaka 565-0871, Japan   ); Oka, K.    (Department of Orthopaedic Surgery, Osaka University, Graduate School of Medicine, 2-2 Yamada-oka, Suita, Osaka 565-0871, Japan   ); Abe, S.    (Department of Orthopaedic Surgery, Osaka University, Graduate School of Medicine, 2-2 Yamada-oka, Suita, Osaka 565-0871, Japan   ); Shigi, A.    (Department of Orthopaedic Surgery, Osaka University, Graduate School of Medicine, 2-2 Yamada-oka, Suita, Osaka 565-0871, Japan   ); Tanaka, H.    (Department of Orthopaedic Surgery, Osaka University, Graduate School of Medicine, 2-2 Yamada-oka, Suita, Osaka 565-0871, Japan   ); Sugamoto, K.    (Department of Orthopaedic Biomaterial Science, Osaka University, Graduate School of Medicine, 2-2 Yamada-oka, Suita, Osaka 565-0871, Japan   ); Yoshikawa, H.    (Department of Orthopaedic Surgery, Osaka University, Graduate School of Medicine, 2-2 Yamada-oka, Suita, Osaka 565-0871, Japan   ); Murase, T.    (Department of Orthopaedic Surgery, Osaka University, Graduate School of Medicine, 2-2  );
  • 초록  

    Summary Objective To quantify the bone density and stress distribution patterns in long-standing cubitus varus and clarify the effects of the deformity on bone density. Design We created three-dimensional computed tomography (CT) elbow models from 21 patients with long-standing cubitus varus deformities without advanced osteoarthritis (OA) and assessed the deformity by superimposing the affected humerus onto a mirror-image of the contralateral normal. Elbows were divided into 13 regions before measuring the bone density of each region and comparing the percentage of high-density volume (%HDV) between affected and normal sides. We constructed finite element models and quantitatively analyzed stress distribution. Results Average degrees of deformities were 20.1° of varus, 6.4° of extension, and 12.7° of internal rotation. The medial side of the affected humerus and ulna, Anteromedial trochlea ( P Medial coronoid ( P = 0.004), and Medial olecranon ( P = 0.049) had significantly higher %HDVs than their normal counterparts. Conversely, %HDVs on the affected lateral side, Capitellum ( P Anterolateral trochlea ( P = 0.010), Posterolateral trochlea ( P Lateral coronoid ( P = 0.007), and Lateral olecranon ( P Anterolateral and Posteromedial quadrants were high ( P = 0.007) and low ( P = 0.007), respectively. The bone density distribution coincided with stress distribution patterns revealed by finite element analysis (FEA), except in the lateral region influenced by forearm rotation. Conclusions Repetitive stress on the medial elbow may alter bone density distribution patterns, probably presenting from early stage of OA.


  • 주제어

    Bone density .   Cubitus varus deformity .   Finite element analysis .   Late complication .   Osteoarthritis .   Stress distribution.  

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