In one of the largest retrospective studies of 39 patients (43 elbows) in whom HO was treated with excision, overall mean flexion-extension arc of motion
was improved from 35[degrees] to 103[degrees] at an average of 13 months follow-up (8).
At a mean follow-up of 26 months, the final arc of motion
in the entire cohort was 88.9[degrees] (range, 30[degrees]-110[degrees]), and 11 patients (58%) had good-excellent results.
With regard to angle of the arc of motion
, there was statistically significant differences identified in both contact area and peak contact pressure throughout the arc of motion
and also between multiple positions with respect to full extension.
The adjustment was especially important because the nonsurgical group had better function at baseline, with significantly stronger grip and pinch strength, better Michigan Hand Questionnaire (MHQ) scores, and significantly better ulnar drift, extensor lag, and arc of motion
than did the surgical group (Arthritis Care Res.
(3) Neer's and Hawkin's tests are often positive, and there may be pain with the arc of motion
. (For more on these and the other tests mentioned here, see Athlete has shoulder problems?
Knee flexion was 90-100 degrees; arc of motion
was 80-90 degrees.
Initially, investigators attributed the change in arc of motion
to soft tissue adaptations, including stretching of the anterior capsular structures, with a corresponding tightening of the posterior capsule (Burkhart et al., 2003c; Burkhart et al., 2003a; Myers et al., 2006; Verna, 1991).
The original pusher arm system relied upon limit switches and cams to control the arc of motion
of each arm.
The arc of motion
for small joints is so intricate that I don't think it can be replaced.
To obtain a concentric joint reduction and a stable arc of motion
, restoration of the osseous stabilizers is a crucial part of the operation when the concomitant fractures were present.