The impact of capitellar arthroplasty on elbow contact mechanics: Implications for implant design

In vitro assessment of the contact mechanics of reverse-engineered distal humeral hemiarthroplasty prostheses

“…The increased stiffness of the metallic hemiarthroplasty prostheses relative to native articular cartilage likely accounts for these differences. Similar decreases in contact area have been described for other hemiarthroplasty prostheses (Liew et al, 2003;Sabo et al, 2011). More recently, an in vitro study employing similar techniques with a commercially available axisymmetric DHH implant demonstrated comparable decreases in elbow joint contact area as reported herein with reverse-engineered prostheses .…”

“…DHH places a metal prosthesis in direct contact with the native articular surfaces of the radial head and greater sigmoid notch of the ulna. The increased stiffness of metal hemiarthroplasty devices relative to cartilage typically results in a decrease in contact area (Liew et al, 2003;Sabo et al, 2011). This may increase cartilage stresses due to the altered contact mechanics, resulting in cartilage wear and post-traumatic osteoarthritis (Dalldorf et al, 1995;Smith and Hughes, 2013).…”

Effect of Radial Head Implant Shape on Joint Contact Area and Location During Static Loading

“…10 The contact of a metallic radial head on articular cartilage can be expected to alter joint contact patterns owing to the stiffness of the implant. 11,12 Changes in implant alignment with respect to the capitellum owing to incorrect positioning or differences in the implant shape relative to the native radial head may also contribute to changes in contact patterns and hence alter articular cartilage loading. Collectively, like any hemiarthroplasty, these changes in stiffness, alignment, and shape have a potential to cause degenerative changes in the opposing cartilaginous surface.…”

“…Collectively, like any hemiarthroplasty, these changes in stiffness, alignment, and shape have a potential to cause degenerative changes in the opposing cartilaginous surface. 11,12 The focus of the current study was on evaluating the effect of radial head implant shape on radiocapitellar contact using computer-assisted surgical techniques to ensure optimal implant positioning and a whole elbow model to mimic a clinically relevant loading environment. The objective of this study was to compare the radiocapitellar contact patterns of 3 radial head implant designs that included axisymmetric, population-based quasi-anatomic, and reverse-engineered patient-specific devices.…”

From radial head to radiocapitellar to total elbow replacement: A case report

“…Biomechanical analysis regarding radiocapitellar arthroplasty shows that available capitellar prostheses do not sufficiently reproduce the anatomy of the capitulum and the radiocapitellar joint [20] . This leads to a decrease in contact area and causes accelerated surface wear [20] .…”