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Radiocapitellar prosthetic arthroplasty in traumatic and post-traumatic complex lesions of the elbow

  • Original Article • ELBOW - ARTHROPLASTY
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Abstract

Radiocapitellar prosthetic arthroplasty is a fascinating new option in the treatment of complex lesions of the elbow. The device has been developed in order to treat primitive and post-traumatic radiocapitellar degenerative arthritis, while preserving the ulnohumeral joint of the elbow. Compared to a radial head resection, it avoids valgus and axial instability of the elbow and forearm preventing ulnohumeral degeneration. Seven patients have been reviewed with a mean of follow-up of 40 months. Two of them presented with an acute trauma and five of them with a post-traumatic degenerative arthritis involving the radial compartment of the elbow. The patients’ evaluation was performed using DASH and Mayo elbow performance score (MEPS). Implant overstuffing, loosening and degenerative changes of the ulnohumeral joint have been monitored with X-ray controls. All patients presented with a marked improvement in elbow function, no signs of overstuffing or ulnohumeral degeneration were observed. Two patients developed a clinically asymptomatic aseptic loosening of the radial press-fit stem. The radiocapitellar prosthetic arthroplasty shows convincing results in the treatment of symptomatic radiocapitellar degenerative arthritis. It has also been effective in acute trauma scenarios in the presence of major osteoarticular wearing or loss of the entire radiocapitellar joint.

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References

  1. Faber KJ (2004) Coronal shear fractures of the distal humerus: the capitellum and trochlea. Hand Clin 20(4):455–464

    Article  PubMed  Google Scholar 

  2. Grantham SA, Norris TR, Bush DC (1981) Isolated fracture of the humeral capitellum. Clin Orthop Relat Res 161(262):269

    Google Scholar 

  3. Singh AP, Dhammi IK, Garg V, Singh AP (2012) Outcome of surgical treatment of type IV capitellum fractures in adults. Chin J Traumatol. 15(4):201–205

    PubMed  Google Scholar 

  4. Mason ML (1954) Some observations on fractures of the head of the radius with a review of one hundred cases. Br J Surg 42(172):123–132

    Article  CAS  PubMed  Google Scholar 

  5. Beingessner DM, Dunning CE, Gordon KD, Johnson JA, King GJ (2004) The effect of radial head excision and arthroplasty on elbow kinematics and stability. J Bone Joint Surg 86-A(8):1730–1739

    Article  PubMed  Google Scholar 

  6. Stephen IB (1981) Excision of the radial head for closed fracture. Acta Orthop Scand 52(4):409–412

    Article  CAS  PubMed  Google Scholar 

  7. Taylor TK, O’Connor BT (1964) The effect upon the inferior radio-ulnar joint of excision of the head of the radius in adults. J Bone Joint Surg Br 46:83–88

    CAS  PubMed  Google Scholar 

  8. Amis AA, Dowson D, Wright V (1980) Elbow joint force predictions for some strenuous isometric actions. J Biomech 13(9):765–775

    Article  CAS  PubMed  Google Scholar 

  9. Rymaszewski LA, Mackay I, Amis AA, Miller JH (1984) Long-term effects of excision of the radial head in rheumatoid arthritis. J Bone Joint Surg Br 66(1):109–113

    CAS  PubMed  Google Scholar 

  10. Herbertsson P, Josefsson PO, Hasserius R, Besjakov J, Nyqvist F, Karlsson MK (2004) Fractures of the radial head and neck treated with radial head excision. J Bone Joint Surg Am 86-A(9):1925–1930

    Article  PubMed  Google Scholar 

  11. Halls AA, Travill A (1964) Transmission of pressures across the elbow joint. Anat Rec 150:243–247

    Article  CAS  PubMed  Google Scholar 

  12. Morrey BF (2000) The elbow and its disorders. Saunders Company, Philadelphia

    Google Scholar 

  13. Sabo MT, Shannon HL, Deluce S, Lalone E, Ferreira LM, Johnson JA, King GJ (2012) Capitellar excision and hemiarthroplasty affects elbow kinematics and stability. J Shoulder Elbow Surg 21(8):1024–1031. doi:10.1016/j.jse.2011.04.019

    Article  PubMed  Google Scholar 

  14. Bain GI, Ashwood N, Baird R, Unni R (2005) Management of Mason type-III radial head fractures with a titanium prosthesis, ligament repair, and early mobilization. Surgical technique. J Bone Joint Surg Am 87(Suppl 1):136–147. doi:10.2106/JBS.D.02710

    Article  PubMed  Google Scholar 

  15. Shore BJ, Mozzon JB, MacDermid JC, Faber KJ, King GJ (2008) Chronic posttraumatic elbow disorders treated with metallicradial head arthroplasty. J Bone Joint Surg Am 90(2):271–280. doi:10.2106/JBJS.F.0153561-667

    Article  PubMed  Google Scholar 

  16. Van Riet RP, Van Glabbeek F, Baumfeld JA, Neale PG, Morrey BF, O’Driscoll SW, An KN (2006) The effect of the orientation of the radial head on the kinematics of the ulnohumeral joint and force transmission through the radiocapitellarjoint. Clin Biomech (Bristol, Avon). 21(6):554–559. doi:10.1016/j.clinbiomech.2006.01.006

    Article  CAS  PubMed  Google Scholar 

  17. Sahu D, Holmes DM, Fitzsimmons JS, Thoreson AR, Berglund LJ, An KN, O’Driscoll SW (2014) Influence of radial head prosthetic design on radiocapitellar joint contact mechanics. J Shoulder Elbow Surg 23(4):456–462

    Article  PubMed  Google Scholar 

  18. Bachman DR, Thaveepunsan S, Park S, Fitzsimmons JS, An KN, O’Driscoll SW (2015) The effect of prosthetic radial head geometry on the distribution and magnitude of radiocapitellar joint contact pressures. J Hand Surg Am. 40(2):281–288

    Article  PubMed  Google Scholar 

  19. Smets S, Govaers K, Jansen N, van Riet R, Schaap M, Van Glabbeek F (2000) The floating radial head prosthesis for comminuted radial head fractures: a multicentre study. Acta Orthop Belg 66(4):353–358

    CAS  PubMed  Google Scholar 

  20. Flinkkila T, Kaisto T, Sirnio K, Hyvonen P, Lppilahti J (2012) Short- to mid-term results of metallic press-fit radial head arthroplasty in unstable injuries of the elbow. J Bone Joint Surg Br 94(6):805–810

    Article  CAS  PubMed  Google Scholar 

  21. Van Rie RP, Sanchez-Sotelo J, Moorey BF (2010) Failure of metal radial head replacement. J Bone Joint Surg Br 92(5):661–667

    Google Scholar 

  22. Heijink A, Morrey BF, Cooney WP 3rd (2008) Radiocapitellar hemiarthroplasty for radiocapitellar arthritis: a report of three cases. J Shoulder Elbow Surg 17(2):e12–e15. doi:10.1016/j.jse.2007.04.009

    Article  PubMed  Google Scholar 

  23. Cheng SL, Morrey BF (2000) Treatment of the mobile, painful arthritic elbow by distraction interposition arthroplasty. J Bone Joint Surg Br 82(2):233–238

    Article  CAS  PubMed  Google Scholar 

  24. Whaley A, Morrey BF, Adams R (2005) Total elbow arthroplasty after previous resection of the radial head and synovectomy. J Bone Joint Surg Br 87(1):47–53

    CAS  PubMed  Google Scholar 

  25. Morrey BF, Adams RA, Bryan RS (1991) Total replacement for post-traumatic arthritis of the elbow. J Bone Joint Surg Br 73(4):607–612

    Article  CAS  PubMed  Google Scholar 

  26. Giannicola G, Sacchetti FM, Postacchini R, Postacchini F (2010) Hemilateral resurfacing arthroplasty in posttraumatic degenerative elbow resulting from humeral capitellum malunion. J Shoulder Elbow Surg 19(1):e12–e17. doi:10.1016/j.jse.2009.07.013

    Article  PubMed  Google Scholar 

  27. Kepler CK, Kummer JL, Lorich DG, Weiland AJ (2010) Radiocapitellar prosthetic arthroplasty for capitellar nonunion. J Shoulder Elbow Surg 19(2):e13–e17. doi:10.1016/j.jse.2009.07.063

    Article  PubMed  Google Scholar 

  28. Jakobsson A (1957) Fracture of the capitellum of the humerus in adults; treatment with intra-articular chrom-cobolt-molybdenum prosthesis. Acta Orthop Scand 26(3):184–190

    CAS  PubMed  Google Scholar 

  29. Sabo MT, Fay K, McDonald CP, Ferreira LM, Johnson JA, King GJ (2010) Effect of coronal shear fractures of the distal humerus on elbow kinematics and stability. J Shoulder Elbow Surg 19(5):670–680. doi:10.1016/j.jse.2010.02.002

    Article  PubMed  Google Scholar 

  30. Dr Shukla, Thoreson AR, Fitzsimmons JS, An KN, O’Driscoll SW (2015) The effect of capitellar impaction fractures on radiocapitellar stability. J Hand Surg Am. 40(3):520–525. doi:10.1016/jhsa.2014.10.031

    Article  Google Scholar 

  31. Sabo MT, Shannon H, Ng J, Ferreira LM, Johnson JA, King GJ (2011) The impact of capitellar arthroplasty on elbow contact mechanism: implications for implant design. Clin Biomech (Bristol, Avon) 26(5):458–463. doi:10.1016/j.clinbiomech.2011.01.007

    Article  CAS  Google Scholar 

  32. Sabo MT, McDonald CP, Ng J, Ferreira LM, Johnson JA, King GJ (2011) A morphological analysis of the humeral capitellum with an interest in prosthesis design. J Shoulder Elbow Surg 20(6):880–884. doi:10.1016/j.jse.2011.01.007

    Article  PubMed  Google Scholar 

  33. Liew VS, Cooper IC, Ferreira LM, Johnson JA, King GJ (2003) The effect of metallic radial head arthroplasty on radiocapitellar joint contact area. Clin Biomech (Bristol, Avon) 18(2):115–118

    Article  Google Scholar 

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Authors and Affiliations

  1. Hand Surgery and Reconstructive Microsurgery Unit, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy

    Prospero Bigazzi & Massimo Ceruso

  2. Orthopaedic Clinic, University of Florence, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy

    Marco Biondi

Authors
  1. Prospero Bigazzi
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  2. Marco Biondi
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  3. Massimo Ceruso
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Correspondence to Prospero Bigazzi.

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The authors declare that they have no conflicts of interest.

Ethical standards

In this work, experiments comply with the current laws of the country in which they were performed. This study was approved by our institution’s scientific research board and conducted in accordance with the World Medical Association Declaration of Helsinki Standard of 1964, as revised in 1983 and 2000. All patients were informed about the study in detail prior to obtaining written informed consent for enrollment, including consent for postoperative RX and CT imaging.

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Bigazzi, P., Biondi, M. & Ceruso, M. Radiocapitellar prosthetic arthroplasty in traumatic and post-traumatic complex lesions of the elbow. Eur J Orthop Surg Traumatol 26, 851–858 (2016). https://doi.org/10.1007/s00590-016-1837-0

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  • DOI: https://doi.org/10.1007/s00590-016-1837-0

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