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http://dx.doi.org/10.5397/CiSE.2011.14.1.140

Clinical Application of Radial Head Prosthesis  

Moon, Jun-Gyu (Department of Orthopedic Surgery, Korea University Medical College)
Publication Information
Clinics in Shoulder and Elbow / v.14, no.1, 2011 , pp. 140-145 More about this Journal
Abstract
Purpose: Installing a radial head prosthesis has developed into a reliable procedure to replace the native radial head for treating unreconstructible radial head fracture when this is associated with an unstable elbow or forearm. A variety of implants have been developed and these are now commercially available. This article reviews the literature related to the indications, the available implants and the surgical techniques of radial head replacement arthroplasty. Materials and Methods: The main indication for a metallic radial head prosthesis is a comminuted fracture that is not amenable to reconstruction, and particularly if it is associated with complex elbow injuries. Excision of the radial head should be avoided in the presence of combined injured ligaments or interosseous membrane injury. Three different implants are available in Korea, including the bipolar, press fit monopolar and loose fit monopolar radial head prostheses. A primary technical goal of radial head arthroplasty is the insertion of an implant that closely replicates the native radial head. The major pitfall when using a metallic radial head prosthesis is the insertion of a longer implant, which results in overstuffing of the radiocapitellar joint. Results and Conclusion: Satisfactory clinical results can be anticipated when a radial head prosthesis is used for the correct indications and when a systemic approach is undertaken to ensure proper sizing. For the future studies, we need data regarding the long term outcomes and comparison of the various types of prostheses.
Keywords
Radial head; Fracture; Replacement;
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1 Ring D, King G. Radial head arthroplasty with a modular metal spacer to treat acute traumatic elbow instability. Surgical technique. J Bone Joint Surg Am. 2008;90 Suppl :63-73.   DOI   ScienceOn
2 Van Glabbeek F, Van Riet RP, Baumfeld JA, et al. Detrimental effects of overstuffing or understuffing with a radial head replacement in the medial collateral- ligament deficient elbow. J Bone Joint Surg Am. 2004;86:2629-35.
3 Birkedal JP, Deal DN, Ruch DS. Loss of flexion after radial head replacement. J Shoulder Elbow Surg. 2004;13:208-13.   DOI   ScienceOn
4 Doornberg JN, Linzel DS, Zurakowski D, Ring D. Reference points for radial head prosthesis size. J Hand Surg Am. 2006;31:53-7.   DOI   ScienceOn
5 Athwal GS, Frank SG, Grewal R, Faber KJ, Johnson J, King GJ. Determination of correct implant size in radial head arthroplasty to avoid overlengthening: surgical technique. J Bone Joint Surg Am. 2010;92 Suppl :250-7.   DOI   ScienceOn
6 Moon JG, Southgate RD, Fitzsimmons JS, O'Driscoll SW. Simple overlay device for determining radial head and neck height. Skeletal Radiol. 2010;39:915-20.   DOI
7 Van Riet RP, van Glabbeek F, de Weerdt W, Oemar J, Bortier H. Validation of the lesser sigmoid notch of the ulna as a reference point for accurate placement of a prosthesis for the head of the radius: a cadaver study. J Bone Joint Surg Br. 2007;89:413-6.   DOI
8 Shors HC, Gannon C, Miller MC, Schmidt CC, Baratz ME. Plain radiographs are inadequate to identify overlengthening with a radial head prosthesis. J Hand Surg Am. 2008;33:335-9.   DOI   ScienceOn
9 Judet T, Garreau de Loubresse C, Piriou P, Charnley G. A floating prosthesis for radial-head fractures. J Bone Joint Surg Br. 1996;78:244-9.
10 Herald J, O'Driscoll S. Complete dissociation of a bipolar radial head prosthesis: a case report. J Shoulder Elbow Surg. 2008;17:e22-3.
11 Moon JG, Berglund LJ, Zachary D, An KN, O'Driscoll SW. Radiocapitellar joint stability with bipolar versus monopolar radial head prostheses. J Shoulder Elbow Surg. 2009;18:779-84.   DOI   ScienceOn
12 Calfee R, Madom I, Weiss AP. Radial head arthroplasty. J Hand Surg Am. 2006;31:314-21.   DOI   ScienceOn
13 O'Driscoll SW, Herald J. Symptomatic failure of snap-on bipolar radial head prosthesis. J Shoulder Elbow Surg. 2009;18:e7-11.   DOI   ScienceOn
14 Burkhart KJ, Mattyasovszky SG, Runkel M et al. Mid-to long-term results after bipolar radial head arthroplasty. J Shoulder Elbow Surg. 2010;19:965-72.   DOI   ScienceOn
15 Schneeberger AG, Sadowski MM, Jacob HA. Coronoid process and radial head as posterolateral rotatory stabilizers of the elbow. J Bone Joint Surg Am. 2004; 86:975-82.
16 Yian E, Steens W, Lingenfelter E, Schneeberger AG. Malpositioning of radial head prostheses: an in vitro study. J Shoulder Elbow Surg. 2008;17:663-70.   DOI   ScienceOn
17 Van Riet RP, Van Glabbeek F, Neale PG, Bortier H, An KN, O'Driscoll SW. The noncircular shape of the radial head. J Hand Surg Am. 2003;28:972-8.   DOI   ScienceOn
18 Koslowsky TC, Beyer F, Germund I, Mader K, Jergas M, Koebke J. Morphometric parameters of the radial neck: an anatomical study. Surg Radiol Anat. 2007;29:279-84.z   DOI
19 Roidis N, Stevanovic M, Martirosian A, Abbott DD, McPherson EJ, Itamura JM. A radiographic study of proximal radius anatomy with implications in radial head replacement. J Shoulder Elbow Surg. 2003;12: 380-4.   DOI   ScienceOn
20 Grewal R, MacDermid JC, Faber KJ, Drosdowech DS, King GJ. Comminuted radial head fractures treated with a modular metallic radial head arthroplasty. Study of outcomes. J Bone Joint Surg Am. 2006;88: 2192-200.   DOI   ScienceOn
21 Moro JK, Werier J, MacDermid JC, Patterson SD, King GJ. Arthroplasty with a metal radial head for unreconstructible fractures of the radial head. J Bone Joint Surg Am. 2001;83:1201-11.
22 Ikeda M, Sugiyama K, Kang C, Takagaki T, Oka Y. Comminuted fractures of the radial head. Comparison of resection and internal fixation. J Bone Joint Surg Am. 2005;87:76-84.   DOI   ScienceOn
23 Popovic N, Lemaire R, Georis P, Gillet P. Midterm results with a bipolar radial head prosthesis: radiographic evidence of loosening at the bone-cement interface. J Bone Joint Surg Am. 2007;89:2469-76.   DOI   ScienceOn
24 Van Riet RP, Sanchez-Sotelo J, Morrey BF. Failure of metal radial head replacement. J Bone Joint Surg Br. 2010;92:661-7.   DOI   ScienceOn
25 Van Riet RP, Van Glabbeek F, Verborgt O, Gielen J. Capitellar erosion caused by a metal radial head prosthesis. A case report. J Bone Joint Surg Am. 2004;86:1061-4.
26 Ring D, Quintero J, Jupiter JB. Open reduction and internal fixation of fractures of the radial head. J Bone Joint Surg Am. 2002;84-A:1811-5.
27 Davidson PA, Moseley JB, Jr. Tullos HS. Radial head fracture. A potentially complex injury. Clin Orthop Relat Res. 1993;224-30.
28 Herbertsson P, Hasserius R, Josefsson PO, et al. Mason type IV fractures of the elbow: a 14- to 46-year follow-up study. J Bone Joint Surg Br. 2009;91:1499-504.   DOI   ScienceOn
29 Johnson JA, Beingessner DM, Gordon KD, Dunning CE, Stacpoole RA, King GJ. Kinematics and stability of the fractured and implant-reconstructed radial head. J Shoulder Elbow Surg. 2005;14:195-201.   DOI   ScienceOn
30 Ikeda M, Oka Y. Function after early radial head resection for fracture: a retrospective evaluation of 15 patients followed for 3-18 years. Acta Orthop Scand. 2000;71:191-4.   DOI
31 Morrey BF, Tanaka S, An KN. Valgus stability of the elbow. A definition of primary and secondary constraints. Clin Orthop Relat Res. 1991;187-95.
32 Moon JG, Southgate RD, Fitzsimmons JS, O'Driscoll SW. Arthroscopic removal of the failed silicone radial head prosthesis. Knee Surg Sports Traumatol Arthrosc. 2009;17:1243-8.   DOI
33 Vanderwilde RS, Morrey BF, Melberg MWVinh TN. Inflammatory arthritis after failure of silicone rubber replacement of the radial head. J Bone Joint Surg Br. 1994;76:78-81.
34 Speed K. Ferrule caps for the head of the radius. Surg Gynecol Obset. 1941;73:845-50.
35 Harrington IJ, Sekyi-Otu A, Barrington TW, Evans DC, Tuli V. The functional outcome with metallic radial head implants in the treatment of unstable elbow fractures: a long-term review. J Trauma. 2001;50:46-52.   DOI
36 Knight DJ, Rymaszewski LA, Amis AA, Miller JH. Primary replacement of the fractured radial head with a metal prosthesis. J Bone Joint Surg Br. 1993;75:572-6.