Ultrasound Evaluation Shows Increase in Laxity After Partial Common Extensor Origin Detachment but Not After Additional Lesion of the Radial Band of the Lateral Collateral Ligament

Overview

Journal Knee Surg Sports Traumatol Arthrosc

Publisher Wiley

Specialties Emergency Medicine
General Surgery
Orthopedics

Date 2021 Aug 29

PMID 34455451

Citations 1

Authors

Paolo Arrigoni

Davide Cucchi

Francesco Luceri

Andrea Zagarella

Michele Catapano

Alessandra Menon

Valentina Bruno

Mauro Gallazzi

Pietro Simone Randelli

Affiliations

Soon will be listed here.

Abstract

Purpose: The lateral elbow musculature conveys a dynamic valgus moment to the elbow, increasing joint stability. Muscular or tendinous lesions to the anterior half of the common extensor origin (CEO) may provoke a deficiency in the elbow dynamic stabilizers, regardless of their traumatic, degenerative, or iatrogenic aetiology. Furthermore, a role for the radial band of the lateral collateral ligament (R-LCL) has been postulated in the aetiology of lateral elbow pain. This study aimed to evaluate the effects of sequential lateral releases with dynamic ultrasound, evaluating its capability to detect lesions of the CEO and of the R-LCL.

Methods: Ultrasound investigation of the lateral compartment of the elbow was performed on nine cadaveric specimens with a 10 MHz linear probe in basal conditions, after the release of the anterior half of the CEO and after complete R-LCL release. The lateral joint line widening (λ) was the primary outcome parameter, measured as the linear distance between the humeral and radial articular surfaces.

Results: The release of the anterior half of the CEO significantly increased λ by 200% compared to the starting position (p = 0.0008) and the previously loaded position (p = 0.0015). Conversely, further release of the R-LCL caused only a marginal, non-significant increase in λ.

Conclusions: Ultrasound evaluation can detect changes related to tendon tears or muscular avulsions of the CEO and can depict lateral elbow compartmental patholaxity by assessing articular space widening while scanning under dynamic stress. However, it cannot reliably define if the R-LCL is injured. Iatrogenic damage to the CEO should be carefully avoided, since it causes a massive increase in compartmental laxity.

Citing Articles

Semiquantitative index of symptomatic minor instability of the lateral elbow at CT arthrography (SMILE index): clinical applicability and reproducibility study.

Zagarella A, Folco G, Monti C, Rizzo A, Arrigoni P, Vismara V Eur Radiol. 2023; 34(4):2742-2750.

PMID: 37704855 DOI: 10.1007/s00330-023-10233-x.

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