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Identification of overlengthening after replacement of the radial head with a bipolar prosthesis

  • Trauma Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

Overlengthening of the radial column leads to insufficient functionality and increased capitellar wear. Methods to detect or prevent overlengthening have been described for monopolar prostheses. The aim of this study was to evaluate whether one such method described by Athwal et al. is also applicable for a bipolar prosthesis.

Materials and methods

The radial heads of six fresh frozen upper extremities were resected. A bipolar radial head prosthesis was implanted in each, and the effects of sequential overlengthening on the alignment of the radiocapitellar and ulnohumeral joint line were recorded by fluoroscopic images. Digital image analysis and estimation of overlengthening followed according to the method described by Athwal et al.

Results

Statistical analysis of the estimated and actual differences between the native state and bipolar replacement of the radial head with stepwise overlengthening of 1.5, 3, 4.5, and 6 mm showed a specificity of 86 % but consistently underestimated the amount of overlengthening with a sensitivity of only 61 %.

Discussion

The method described by Athwal et al. for the identification of overlengthening by a monopolar prosthesis was not found to be reliable for ruling out or quantifying overlengthening of the tested bipolar prosthesis. However, the use of the method to detect (rule in) overlengthening may be acceptable in certain circumstances. A reliable method for postoperative quantification of overlengthening by bipolar prostheses has still to be found.

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Acknowledgments

KW, KJB, and LPM receive payments from the Tornier company (Tornier, Saint-Ismier, France) for ongoing consultancy. The other authors, their immediate family, and any research foundation with which they are affiliated did not receive any financial payments or other benefits from any commercial entity related to the subject of this article. The study has been reviewed and approved by the local ethics committee.

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Authors and Affiliations

  1. Center for Orthopedic and Trauma Surgery, University Medical Center, Cologne, Germany

    K. Wegmann, J. Lamsfuss, C. Ries & L. P. Müller

  2. Institute of Anatomy I, University of Cologne, Cologne, Germany

    W. F. Neiss

  3. Institute of Medical Statistics, Informatics and Epidemiology, University of Cologne, Cologne, Germany

    J. Franklin

  4. Cologne Center for Musculoskeletal Biomechanics, Medical Faculty, University of Cologne, Josef-Stelzmann-Str.9, 50924, Cologne, Germany

    K. Wegmann, C. Ries & L. P. Müller

  5. Clinic for Shoulder Surgery, Bad Neustadt/Saale, Germany

    K. J. Burkhart

Authors
  1. K. Wegmann
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  2. J. Lamsfuss
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  3. C. Ries
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  4. W. F. Neiss
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  5. J. Franklin
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  6. L. P. Müller
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  7. K. J. Burkhart
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Corresponding author

Correspondence to K. Wegmann.

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Wegmann, K., Lamsfuss, J., Ries, C. et al. Identification of overlengthening after replacement of the radial head with a bipolar prosthesis. Arch Orthop Trauma Surg 135, 1669–1674 (2015). https://doi.org/10.1007/s00402-015-2333-4

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  • DOI: https://doi.org/10.1007/s00402-015-2333-4

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