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Do the radial head prosthesis components fit with the anatomical structures of the proximal radioulnar joint?

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Abstract

Purpose

The fitting accuracy of radial head components has been investigated in the capitulo-radial joint, and reduced contact after prosthetic replacement of the radial head has been observed. The kinematics of the proximal radioulnar joint (PRUJ) are affected by radial head arthroplasty as well, but have not yet been investigated in this regard.

Methods

The elbow joints of 60 upper extremities of formalin-fixed body donors were disarticulated to obtain a good view of the PRUJ. Each specimen was mounted on the examining table and radial head position in the native PRUJ was assessed in neutral position, full pronation, and full supination. Measurements were repeated after implantation of mono- and bi-polar prostheses.

Results

Analysis of the distribution of the joint contacts in the compartments showed significant differences after radial head replacement. In comparison to the native joint, after bipolar and monopolar radial head replacement, the physiological shift of the proximal radius was altered.

Discussion

The physiological shift of the joint contact of the radial head from anterior to posterior during forearm rotation that was found in the native joint in our cadaver model was not observed after prosthetic replacement. With higher conformity and physiological kinematic of radial head prostheses, possibly lower shear forces and lower contact pressures would be generated.

Clinical relevance

The tested radial head prostheses do not replicate the physiological kinematics of the radial head. Further development in the prosthesis design has to be made. The meticulous reconstruction of the annular ligament seems to be of importance to increase joint contact.

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References

  1. Baeyens JP, Van Glabbeek F, Goossens M, Gielen J, Van Roy P, Clarys JP (2006) In vivo 3D arthrokinematics of the proximal and distal radioulnar joints during active pronation and supination. Clin Biomech (Bristol, Avon) 21(Suppl 1):S9–S12. doi:10.1016/j.clinbiomech.2005.09.008

    Article  Google Scholar 

  2. Beredjiklian PK, Nalbantoglu U, Potter HG, Hotchkiss RN (1999) Prosthetic radial head components and proximal radial morphology: a mismatch. J Shoulder Elbow Surg 8:471–475

    Article  CAS  PubMed  Google Scholar 

  3. Chantelot C, Wavreille G, Dos Remedios C, Landejerit B, Fontaine C, Hildebrand H (2008) Intra-articular compressive stress of the elbow joint in extension: an experimental study using Fuji films. Surg Radiol Anat 30:103–111. doi:10.1007/s00276-007-0297-y

    Article  CAS  PubMed  Google Scholar 

  4. Doornberg JN, Parisien R, van Duijn PJ, Ring D (2007) Radial head arthroplasty with a modular metal spacer to treat acute traumatic elbow instability. J Bone Joint Surg Am 89:1075–1080. doi:10.2106/JBJS.E.01340

    Article  PubMed  Google Scholar 

  5. Dotzis A, Cochu G, Mabit C, Charissoux JL, Arnaud JP (2006) Comminuted fractures of the radial head treated by the Judet floating radial head prosthesis. J Bone Joint Surg Br 88:760–764. doi:10.1302/0301-620X.88B6.17415

    Article  CAS  PubMed  Google Scholar 

  6. Götz LPSR (2013) Komplexe instabile Luxationsfrakturen des Ellenbogens—Klinische Ergebnisse nach Versorgung unter prothetischem Ersatz des Radiusköpfchens. Obere Extremität 8:22–26

    Article  Google Scholar 

  7. Grewal R, MacDermid JC, Faber KJ, Drosdowech DS, King GJ (2006) Comminuted radial head fractures treated with a modular metallic radial head arthroplasty. Study of outcomes. J Bone Joint Surg Am 88:2192–2200. doi:10.2106/JBJS.E.00962

    Article  PubMed  Google Scholar 

  8. Gupta GG, Lucas G, Hahn DL (1997) Biomechanical and computer analysis of radial head prostheses. J Shoulder Elbow Surg 6:37–48 (S10582746(97)90069-0 [pii])

    Article  CAS  PubMed  Google Scholar 

  9. Harrington IJ, Sekyi-Otu A, Barrington TW, Evans DC, Tuli V (2001) The functional outcome with metallic radial head implants in the treatment of unstable elbow fractures: a long-term review. J Trauma 50:46–52

    Article  CAS  PubMed  Google Scholar 

  10. King GJ, Zarzour ZD, Patterson SD, Johnson JA (2001) An anthropometric study of the radial head: implications in the design of a prosthesis. J Arthroplast 16:112–116. doi:10.1054/arth.2001.16499

    Article  CAS  Google Scholar 

  11. Koslowsky TC, Germund I, Beyer F, Mader K, Krieglstein CF, Koebke J (2007) Morphometric parameters of the radial head: an anatomical study. Surg Radiol Anat SRA 29:225–230. doi:10.1007/s00276-007-0197-1

    Article  CAS  PubMed  Google Scholar 

  12. 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) 18:115–118 (S0268003302001729 [pii])

    Article  Google Scholar 

  13. Moghaddam A, Lennert A, Studier-Fischer S, Wentzensen A, Zimmermann G (2008) Prosthesis after comminuted radial head fractures : midterm results. Unfallchirurg 111:997–1004. doi:10.1007/s00113-008-1514-9

    Article  CAS  PubMed  Google Scholar 

  14. Moungondo F, El Kazzi W, van Riet R, Feipel V, Rooze M, Schuind F (2010) Radiocapitellar joint contacts after bipolar radial head arthroplasty. J Shoulder Elbow Surg 19:230–235. doi:10.1016/j.jse.2009.09.015

    Article  PubMed  Google Scholar 

  15. Popovic N, Lemaire R, Georis P, Gillet P (2007) Midterm results with a bipolar radial head prosthesis: radiographic evidence of loosening at the bone-cement interface. J Bone Joint Surg Am 89:2469–2476. doi:10.2106/JBJS.F.00723

    Article  PubMed  Google Scholar 

  16. Ring D, King G (2008) Radial head arthroplasty with a modular metal spacer to treat acute traumatic elbow instability. Surgical technique. J Bone Joint Surg Am 90(Suppl 2 Pt 1):63–73. doi:10.2106/JBJS.G.01248

    PubMed  Google Scholar 

  17. van Riet RP, Van Glabbeek F, Baumfeld JA, Neale PG, Morrey BF, O’Driscoll SW, An KN (2004) The effect of the orientation of the noncircular radial head on elbow kinematics. Clin Biomech (Bristol, Avon) 19:595–599. doi:10.1016/j.clinbiomech.2004.03.002

    Article  Google Scholar 

  18. Wegmann K, Dargel J, Burkhart KJ, Bruggemann GP, Muller LP (2012) The Essex Lopresti lesion. Strateg Trauma Limb Reconstr 7:131–139. doi:10.1007/s11751-012-0149-0

    Article  CAS  Google Scholar 

  19. Weiss AP, Hastings H 2nd (1992) The anatomy of the proximal radioulnar joint. J Shoulder Elbow Surg 1:193–199. doi:10.1016/1058-2746(92)90013-S

    Article  CAS  PubMed  Google Scholar 

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Conflict of interest

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.

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Authors and Affiliations

  1. Centre for Orthopaedic and Trauma Surgery, University Medical Centre, Cologne, Germany

    Kilian Wegmann, Moritz K. Hain, Christian Ries & Lars P. Müller

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

    Wolfram F. Neiss

  3. Klinik für Schulterchirurgie, Rhön-Klinikum, Bad Neustadt/Saale, Germany

    Klaus J. Burkhart

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  1. Kilian Wegmann
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  2. Moritz K. Hain
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  3. Christian Ries
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  4. Wolfram F. Neiss
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  5. Lars P. Müller
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  6. Klaus J. Burkhart
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Correspondence to Kilian Wegmann.

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Wegmann, K., Hain, M.K., Ries, C. et al. Do the radial head prosthesis components fit with the anatomical structures of the proximal radioulnar joint?. Surg Radiol Anat 37, 743–747 (2015). https://doi.org/10.1007/s00276-014-1407-2

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  • DOI: https://doi.org/10.1007/s00276-014-1407-2

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