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Can Ulnar Variance Be Used to Detect Overstuffing After Radial Head Arthroplasty?

  • Basic Research
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Clinical Orthopaedics and Related Research®

Abstract

Background

Overstuffing of the radiocapitellar joint during metallic radial head arthroplasty has been reported to cause loss of elbow flexion, capitellar erosion, and early-onset osteoarthritis. Although this is known, there is no agreed-on measurement approach to determine whether overstuffing has occurred.

Questions/purposes

We therefore hypothesized that overlengthening the radial head during radial head arthroplasty changes the ulnar variance in the wrist.

Methods

Seven cadaveric radii were implanted with radial head prostheses of increasing thickness. Each specimen was implanted successively with increasingly thick radial head prostheses measuring 2, 4, and 6 mm thicker than the native radial head, and radiographs were taken after implantation of each prosthesis. The ulnar variance with each prosthesis was measured using the method of perpendiculars.

Results

The ulnar variance of the native and 2-mm (p = 0.04), 4-mm (p = 0.008), and 6-mm (p = 0.008) overly thick radial head prosthesis-implanted states decreased significantly with each incremental increase in prosthetic head thickness.

Conclusions

Implantation of thicker radial head prostheses decreased the ulnar variance. Our results indicate ulnar variance could be used to detect overstuffing of radial head prostheses.

Clinical Relevance

The simplicity and reliability of ulnar variance make it a potentially useful indicator of overlengthening after radial head arthroplasty.

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Authors and Affiliations

  1. Department of Orthopedic Surgery, Korea University Guro Hospital, 97 Gurodong-gil, Guro-gu, Seoul, 152-703, Korea

    Jun-Gyu Moon MD, PhD, Jin-Ho Hong MD, Nitin Bither MD & Won-Yong Shon MD, PhD

Authors
  1. Jun-Gyu Moon MD, PhD
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  2. Jin-Ho Hong MD
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  3. Nitin Bither MD
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  4. Won-Yong Shon MD, PhD
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Corresponding author

Correspondence to Jun-Gyu Moon MD, PhD.

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Each author certifies that he or she, or a member of his or her immediate family, has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.

All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research editors and board members are on file with the publication and can be viewed on request.

Clinical Orthopaedics and Related Research neither advocates nor endorses the use of any treatment, drug, or device. Readers are encouraged to always seek additional information, including FDA-approval status, of any drug or device prior to clinical use.

Each author certifies that his or her institution approved or waived approval for the human protocol for this investigation and that all investigations were conducted in conformity with ethical principles of research.

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Moon, JG., Hong, JH., Bither, N. et al. Can Ulnar Variance Be Used to Detect Overstuffing After Radial Head Arthroplasty?. Clin Orthop Relat Res 472, 727–731 (2014). https://doi.org/10.1007/s11999-013-3277-z

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  • DOI: https://doi.org/10.1007/s11999-013-3277-z

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