Kinematics and functional characteristics of the Pritchard ERS unlinked total elbow arthroplasty

This study examined the kinematic characteristics of the Pritchard ERS elbow-resurfacing system, with special attention paid to the effects of the radial head component. The kinematics between the ulna and humerus were assessed in 6 human cadaveric specimens by an electromagnetic tracking system throughout a full flexion/extension range of motion. The elbows were studied under 2 loading conditions, in 3 orientations (neutral, varus, and valgus), and under 4 surgical conditions. The varus/valgus and internal/external rotation laxities were used to assess the condition differences. Specifically, the maximum laxities throughout the extension motion were compared, as were the laxities at 40 degrees, 75 degrees, and 110 degrees of flexion. Both the varus/valgus and internal/external rotation laxities of the ulnohumeral joint increased after total elbow arthroplasty (TEA) implantation, with and without a radial head. This increase was most evident in the extension portion of the arc of motion. At 40 degrees of flexion, the varus/valgus laxity of the intact elbow was 4 degrees +/- 2 degrees versus 11 degrees +/- 8 degrees for a TEA with a radial head and 22 degrees +/- 11 degrees for a TEA without a radial head while the elbow was being subjected to compressive loads via the biceps, brachialis, and triceps. The kinematic data demonstrate a consistent increase in laxity with the Pritchard ERS TEA. They also indicate that a radial head component is necessary for optimal tracking and stability of the ERS arthroplasty.