Determination of Correct Implant Size in Radial Head Arthroplasty to Avoid Overlengthening

Frank, Simon G.; Grewal, Ruby; Johnson, James A.; Faber, Kenneth J.; King, Graham J.W.; Athwal, George S.

doi:10.2106/jbjs.h.01161

Cited by 99 publications

(38 citation statements)

References 20 publications

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“…Van Glabbeek et al [23] also showed how overstuffing the radiocapitellar joint by even 2.5 mm resulted in increased joint pressures. Frank et al [6] reported that intraoperative visualization of a gap in the medial ulnohumeral joint may indicate overstuffing. Doornberg et al [3] recommended sizing the radial head so that it was even with the articular surface of the coronoid, and we have found better results using this guideline.…”

Section: Discussionmentioning

confidence: 99%

Fixation Versus Replacement of Radial Head in Terrible Triad: Is There a Difference in Elbow Stability and Prognosis?

Watters

Garrigues

Ring

et al. 2014

Clinical Orthopaedics &Amp; Related Research

111

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Background Surgical treatment for terrible triad injuries of the elbow (defined as elbow dislocations with concomitant fractures of the radial head and coronoid) remains a challenging clinical problem. Specifically, the question of whether to repair or replace the radial head remains controversial. Questions/purposes We compared patients with terrible triad injuries of the elbow whose radial head fracture was treated with either internal fixation and internal fixation (ORIF) or radial head arthroplasty in terms of (1) clinical outcome measures (DASH and Broberg-Morrey scores, ROM), (2) elbow stability and radiographic signs of arthrosis, and (3) complications and reoperation rates. Methods Retrospective review identified 39 patients with terrible triad injuries and minimum 18-month complete clinical and radiographic followup (mean, 24 months; range, 18-53 months). Patients were managed with a standard algorithm consisting of (1) repair (n = 9) or replacement (n = 30) of the radial head, (2) repair of the lateral ulnar collateral ligament, and (3) repair of the coronoid fracture. During the study period, the radial head generally was internally fixed when there were fewer than four articular fragments; otherwise, it was replaced. Evaluation included the DASH score, the Broberg-Morrey index, measurements of elbow stability and motion, and radiographic assessment for signs of arthrosis; chart review was performed for complications and reoperations. Complete followup was available on 87% (39 of 45 patients).

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Section: Discussionmentioning

confidence: 99%

Fixation Versus Replacement of Radial Head in Terrible Triad: Is There a Difference in Elbow Stability and Prognosis?

Watters

Garrigues

Ring

et al. 2014

Clinical Orthopaedics &Amp; Related Research

111

View full text Add to dashboard Cite

show abstract

“…The failure to select an implant that best approximates the native radial head dimensions leads to an alteration in joint architecture and mechanics, which may lead to poor clinical and radiologic outcomes. 4,8,11,13 There are a number of published techniques that describe methods to determine radial head implant height, 2,6 but there is a paucity of information that addresses the manner in which the diameter of the native radial head should be measured. To our knowledge, there is one published article that looks at measuring the 3 common diameters (D-MAX, D-MIN, D-DISH) as we have done in this study.…”

Section: Discussionmentioning

confidence: 99%

“…The failure to appropriately size the radial head prosthesis (and, in particular, oversizing of the radial head) leads to an alteration in joint architecture and mechanics that results in restricted elbow motion, capitellar erosion, pain, and earlyonset osteoarthritis. 4,6,8,11,13 To prevent overlengthening or ''overstuffing'' of the implant, a number of techniques have been described to size the height of the radial head. 2,3,6,8 None of these studies, however, have reported on techniques to reliably choose the correct radial head diameter.…”

mentioning

confidence: 99%

The effect of fracture comminution on the reliability and accuracy of radial head sizing

Abdulla

Langohr

Gladwell

et al. 2015

Journal of Shoulder and Elbow Surgery

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“…The remaining ossifications (n=5) were located in the ventral aspect of the elbow and could be classified as grade 1 [11]. There was no implant loosening, no bone resorption and no evident radiocapitellar overstuffing [9].…”

Section: Entire Cohortmentioning

confidence: 99%

Monobloc radial head prostheses in complex elbow injuries: results after primary and secondary implantation

Katthagen

Jensen

Lill

et al. 2012

International Orthopaedics (SICOT)

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Purpose Dislocations of components, loosening of the stem, overstuffing and removal in up to 24 % of common radial head prostheses (RHP) after implantation in complex elbow injuries signal the need for improvement. The latest biomechanical evidence shows advantages for monopolar designs. Clinical results after primary and secondary implantation of the newly designed press-fit monobloc monopolar RHP in cases of complex elbow injury are evaluated. Methods Twenty-nine patients [median age 60 years (29-86)] were followed up retrospectively for a median of 25 months (7-54) post-operatively. Subjective parameters, the Mayo Elbow Performance Score (MEPS), the Broberg and Morrey score (BMS), latest radiographs and complications were evaluated. Results MEPS and BMS averaged 87.2±12.9 and 81.1±11.9 points, respectively. No case of implant loosening was observed; the RHP had to be removed in one case (3 %). The overall complication and revision rate was higher after secondary (53 %) than after primary (19 %) implantation. Conclusions Satisfactory clinical results and low short-term removal rates emphasise the practicality of monobloc monopolar RHP. Differentiated treatment of complex elbow fracturedislocations is compulsory to avoid the need for secondary RHP implantation which carries a higher complication rate.

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Determination of Correct Implant Size in Radial Head Arthroplasty to Avoid Overlengthening

Cited by 99 publications

References 20 publications

Fixation Versus Replacement of Radial Head in Terrible Triad: Is There a Difference in Elbow Stability and Prognosis?

Fixation Versus Replacement of Radial Head in Terrible Triad: Is There a Difference in Elbow Stability and Prognosis?

The effect of fracture comminution on the reliability and accuracy of radial head sizing

Monobloc radial head prostheses in complex elbow injuries: results after primary and secondary implantation

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