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University of Florida Thesis Or Dissertation Formatting CONTACT MECHANICS AND THREE-DIMENSIONAL ALIGNMENT OF NORMAL DOG ELBOWS By LAURA C. CUDDY A THESIS PRESENTED TO THE GRADUATE SCHOOL OF THE UNIVERSITY OF FLORIDA IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF MASTER OF SCIENCE UNIVERSITY OF FLORIDA 2011 1 © 2011 Laura Cuddy 2 To my family 3 ACKNOWLEDGMENTS To the UF Surgery Service, my surrogate family, I am eternally grateful for the opportunity to train in one of the best residency programs worldwide. I hope I make you proud. To my mentors, Dr. Dan Lewis and Dr. Antonio Pozzi for their intellectual support, dedication and hard work. To Dr. Bryan Conrad and Dr. Scott Banks, for the many long and frustrating hours spent analyzing kinematic data. To Dr. MaryBeth Horodyski for her consistent and cheerful guidance with statistical analysis. To my fellow Irishman Dr. Noel Fitzpatrick for his intellectual and financial contributions, without which this study would not have been possible. To the UF College of Veterinary Medicine Graduate Office for their financial support and guidance. To my resident mates, past and present, thank you for all your support and guidance during our journey. To my family, for their continuing support and encouragement. 4 TABLE OF CONTENTS page ACKNOWLEDGMENTS .................................................................................................. 4 LIST OF TABLES ............................................................................................................ 7 LIST OF FIGURES .......................................................................................................... 8 LIST OF ABBREVIATIONS ........................................................................................... 10 ABSTRACT ................................................................................................................... 11 CHAPTER 1 INTRODUCTION .................................................................................................... 13 History of Elbow Research ...................................................................................... 13 Elbow ...................................................................................................................... 14 Anatomy ........................................................................................................... 14 Ultrastructure and Composition of the Normal MCP ......................................... 15 Medial Coronoid Pathology ..................................................................................... 17 Epidemiology .................................................................................................... 17 Etiopathogenesis .............................................................................................. 19 Genetics ..................................................................................................... 19 Abnormal endochondral ossification .......................................................... 20 Abnormal bone structure ............................................................................ 20 Abnormal elbow biomechanics .................................................................. 21 Histopathology .................................................................................................. 25 Diagnosis .......................................................................................................... 28 Treatment for Medial Coronoid Disease ................................................................. 29 Conservative management ............................................................................... 29 Removal of pathologic cartilage and bone........................................................ 31 Arthroscopy ................................................................................................ 31 Sub-total coronoidectomy .......................................................................... 32 Biceps Ulnar Release Procedure ..................................................................... 33 Corrective Osteotomies .................................................................................... 34 Ulnar osteotomy ......................................................................................... 34 Humeral osteotomy .................................................................................... 35 Elbow Denervation ........................................................................................... 37 Salvage Procedures ......................................................................................... 37 Medial compartment resurfacing ................................................................ 37 Total elbow arthroplasty ............................................................................. 38 2 CONTACT MECHANICS AND 3D ALIGNMENT OF NORMAL DOG ELBOWS .... 39 Background ............................................................................................................. 39 5 Materials and Methods............................................................................................ 41 Specimen Preparation ...................................................................................... 41 Testing Protocol ............................................................................................... 46 Testing Sequence ............................................................................................ 47 Data Analysis ................................................................................................... 47 Statistical Analysis ............................................................................................ 50 Results .................................................................................................................... 50 Contact Mechanics ........................................................................................... 50 Anatomic Location of Peak Contact Pressure .................................................. 54 3D Alignment .................................................................................................... 55 Humeroradial articulation ........................................................................... 55 Humeroulnar articulation ............................................................................ 56 Proximal radioulnar articulation .................................................................. 57 Discussion .............................................................................................................. 64 3 EFFECT OF PROXIMAL ULNAR ROTATIONAL OSTEOTOMY ON CONTACT MECHANICS AND 3D ALIGNMENT OF NORMAL DOG ELBOWS ....................... 68 Background ............................................................................................................. 68 Materials and Methods............................................................................................ 70 Specimen Preparation ...................................................................................... 70 Testing Protocol ............................................................................................... 70 Testing Sequence ............................................................................................ 70 Data Analysis ................................................................................................... 72 Statistical Analysis ............................................................................................ 74 Results .................................................................................................................... 74 Contact Mechanics ........................................................................................... 74 3D Alignment .................................................................................................... 76 Humeroradial articulation ........................................................................... 76 Humeroulnar articulation ............................................................................ 76 Proximal radioulnar articulation .................................................................. 76 Proximal ulna-distal ulna ............................................................................ 80 Discussion .............................................................................................................. 81 4 CONCLUSION ........................................................................................................ 86 LIST OF REFERENCES ............................................................................................... 91 BIOGRAPHICAL SKETCH .......................................................................................... 103 6 LIST OF TABLES Table page 1-1 Modified Outerbridge Scoring System for arthroscopic evaluation of cartilage pathology ............................................................................................................ 31 2-1 Contact mechanical data acquired from the medial and lateral elbow compartments at each of the nine elbow poses tested ....................................... 52 2-2 Static 3D alignment of the humeroradial articulation for the nine elbow poses tested .................................................................................................................. 58 2-3 Static 3D alignment of the humeroulnar articulation for the nine elbow poses tested .................................................................................................................
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