Research

Through detailed biomechanical studies, our research team is gaining a better understanding of the forces and factors necessary for elbow stability and function. In turn, this knowledge is leading to insights that are improving the approaches used to treat elbow injuries.

Radial head replacement arthroplasty

Graphic showing use of a radial head implant in an injured elbow for restoration of movement and stability.

This image shows a radial head implant (red portion) in the elbow joint, used when the radial head is severely injured. Dr. O'Driscoll is leading efforts to improve use of these implants.

One focus of our research is radial head replacement in elbow injuries. Radial head replacement, also called radial head arthroplasty, is an artificial joint prosthesis. Indications for radial head replacement include fractures that can't be reconstructed, that are displaced or fragmented (comminuted), or that have associated ligamentous disruption.

Several types of radial head implants are available, with different head and stem configurations. Although such implants have been used clinically for decades, much remains unknown about the biomechanics and kinematics of radial head prostheses.

Our lab continues to investigate the best solutions for these elbow injuries.

Coronoid fracture classification system for elbow instability

Dr. O'Driscoll's coronoid fracture classification system includes fracture type and subtype and description.

This image shows Dr. O'Driscoll's coronoid fracture classification system, which helps surgeons determine the best course of action to treat posteromedial rotatory instability.

Recurrent elbow instability is a complex problem that continues to present management challenges to general orthopedic surgeons and subspecialists. Instability that is recurrent is usually lateral in nature but can be medial or a combination.

Since the publication of Dr. O'Driscoll's original study on posterolateral rotatory instability of the elbow, investigators have made significant advances in the understanding, diagnosis and treatment of recurrent instability.

Our lab has since learned that deficiencies of the coronoid or radial head or both must be addressed. The most important postoperative rehabilitation concern is to avoid the varus gravitational stresses that are applied to the elbow, such as when grabbing a beverage from the refrigerator.

Based on Dr. O'Driscoll's detailed laboratory studies and his extensive clinical experience with the elbow, he has devised an effective, functional coronoid fracture classification system that can help surgeons decide on the best course of action to treat posteromedial rotatory instability as well.

Fracture types in the coronoid fracture classification:

  • Tip. Fracture subtype 1 is less than or equal to 2 millimeters (mm) of coronoid bony height (flake fracture). Subtype 2 is greater than 2 mm of coronoid height.
  • Anteromedial. Fracture subtype 1 is the anteromedial facet. Subtype 2 is the anteromedial facet plus the tip. Subtype 3 is the anteromedial facet plus the sublime tubercle, with or without the tip.
  • Basal. Fracture subtype 1 is the coronoid body and base. Subtype 2 are transulnar basal coronoid fractures.

Collaborators

Research collaboration is a key element of advancing treatment options for elbow conditions. Our lab works with numerous researchers and physicians both at Mayo Clinic and around the world.

Mayo Clinic collaborators

Our current Mayo Clinic collaborators include:

External collaborators

Our lab's current external collaborators include:

Glen I. Abdo, M.D., M.P.H.
New York Medical College
Denville, New Jersey

Daniel R. Bachman, M.D.
Cincinnati Children's Hospital
Cincinnati, Ohio

Dorcas E. Beaton, Ph.D.
Keenan Research Centre
Li Ka Shing Knowledge Institute
St. Michael's Hospital
Toronto, Ontario, Canada

Enrico Bellato, M.D.
University of Turin Medical School
Department of Orthopaedics and Traumatology of Orbassano
San Luigi Gonzaga Hospital
Turin, Italy

Marion Burnier, M.D.
Edouard Herriot Hospital
Lyon, France

Kun-Hui Chen, M.D.
Taipei Veterans General Hospital
Taipei, Taiwan

Gregory Della Rocca, M.D., Ph.D.
University of Missouri, University Hospital
Columbia, Missouri

Bassem T. Elhassan, M.D.
Massachusetts General Hospital
Boston, Massachusetts

Michal Harasymczuk, M.D.
University of Medical Sciences
Poznan, Poland

Andrew R. Jensen, M.D.
UCLA Health
Los Angeles, California

Jesse B. Jupiter, M.D.
Massachusetts General Hospital
Boston, Massachusetts

Justin C. Kennon, M.D.
Tennessee Orthopaedic Alliance
Knoxville, Tennessee

Youngbok Kim, M.D.
Inje University, Haeundae Paik Hospital
Busan, South Korea

Graham J.W. King, M.D.
St. Joseph's Health Centre
Toronto, Ontario, Canada

Jae-Man Kwak, M.D.
College of Medicine
Eulji University
Uijeongbu, South Korea

Michael D. McKee, M.D.
Banner — University Medical Center Phoenix
University of Arizona College of Medicine
Phoenix, Arizona

Marie Caroline Merlet, M.D.
Department of Orthopedic Surgery and Traumatology
Rouen University Hospital
Rouen, France

Masa Minami, M.D., Ph.D.
Kyoto Prefectural University of Medicine
Kyoto, Japan

Sebastian A. Müller, M.D.
University Hospital Basel
Canton of Basel-Stadt, Switzerland

Julia A. Müller-Lebschi, M.D.
Kantonsspital Baselland
Basel, Switzerland

Gaku Niitsuma, M.D., Ph.D.
Showa University School of Medicine
Tokyo, Japan

Hiroki Nishikawa, M.D., Ph.D.
Showa University School of Medicine
Tokyo, Japan

Jorge L. Rojas Lievano, M.D., M.P.H.
Pontificia Universidad Javeriana
Bogotá, Colombia

Dani Rotman, M.D.
Sackler Faculty of Medicine
Tel Aviv Sourasky Medical Center
Tel Aviv, Israel

Maegan N. Shields, M.D., M.S.
University of Toronto
Toronto, Ontario

Dave Shukla, M.D.
Icahn School of Medicine at Mount Sinai
New York, New York

Chad E. Songy, M.D.
UAMS Health Orthopaedic and Sports Medicine
University of Arkansas for Medical Sciences
Fayetteville, Arkansas

Ausberto R. Velasquez Garcia, M.D.
Rothman Orthopaedics
Orlando, Florida

Valeria Vismara, M.D.
University of Milan Medical School
Milan, Italy

Arnaud Walch, M.D.
Edouard Herriot Hospital
Lyon, France

Joanna Walecka, M.D., Ph.D.
Rehasport Clinic
Poznan, Poland