Date of Award

2010

Degree Type

Thesis

Degree Name

Master of Science

Program

Medical Biophysics

Supervisor

Dr. Graham JW King

Second Advisor

Dr. James A Johnson

Abstract

Pathologies affecting the humeral capitellum include osteochondritis dissecans (OCD), fracture, and arthrosis. This work assessed the capitellum's role in elbow kinematics and stability to help guide clinical treatment decisions. The effects of OCD lesions and coronal shear distal humeral fractures were examined using a cadaveric model in an elbow simulator. Capitellar OCD lesions did not cause significant kinematic alterations, while fractures involving the trochlea did. The trochlea is a critical stabilizer whereas the capitellum is not in the setting of intact ligaments. However, given the capitellum's other functions, a detailed anthropometric analysis of the capitellum was undertaken and spherical and anatomically-inspired capitellar hemiarthroplasties were designed and manufactured. RadiocapiteIlar contact mechanics were assessed using casting techniques. Both hemiarthroplasties demonstrated reductions in contact area, and incompletely reproduced the native articular contact shape. The theoretical advantages of a more anatomical capitellar prosthesis shape may not be realized clinically, suggesting a spherical prosthesis, which is easier to manufacture and implant, may be preferable. Further studies are required to determine the effect of capitellar hemiarthroplasty on radiai head wear in-vivo

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