Do the radial head prosthesis components fit with the anatomical structures of the proximal radioulnar joint?
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Do the radial head prosthesis components fit with the anatomical structures of the proximal radioulnar joint? / Wegmann, Kilian; Hain, Moritz K; Ries, Christian; Neiss, Wolfram F; Müller, Lars P; Burkhart, Klaus J.
in: SURG RADIOL ANAT, Jahrgang 37, Nr. 7, 09.2015, S. 743-7.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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T1 - Do the radial head prosthesis components fit with the anatomical structures of the proximal radioulnar joint?
AU - Wegmann, Kilian
AU - Hain, Moritz K
AU - Ries, Christian
AU - Neiss, Wolfram F
AU - Müller, Lars P
AU - Burkhart, Klaus J
PY - 2015/9
Y1 - 2015/9
N2 - 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.
AB - 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.
KW - Aged
KW - Aged, 80 and over
KW - Arthroplasty, Replacement, Elbow/methods
KW - Biomechanical Phenomena
KW - Cadaver
KW - Dissection
KW - Elbow Joint/anatomy & histology
KW - Elbow Prosthesis
KW - Female
KW - Humans
KW - Male
KW - Prosthesis Design
KW - Prosthesis Implantation/methods
KW - Radius/anatomy & histology
KW - Range of Motion, Articular/physiology
KW - Risk Factors
KW - Sensitivity and Specificity
U2 - 10.1007/s00276-014-1407-2
DO - 10.1007/s00276-014-1407-2
M3 - SCORING: Journal article
C2 - 25542245
VL - 37
SP - 743
EP - 747
JO - SURG RADIOL ANAT
JF - SURG RADIOL ANAT
SN - 0930-1038
IS - 7
ER -