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Influence of prosthetic design on radiocapitellar concavity-compression stability
Cholawish Chanlalit1, Dave R Shukla, James S Fitzsimmons
1Department of Orthopedics, Faculty of Medicine, HRH Princess Maha Chakri Sirindhorn Medical Center, Srinakhrinwirot University, Bangkok, Thailand.
Background:
Radial head prostheses are available with multiple geometric properties. The effect of design features on radiocapitellar stability has not been investigated.
Hypothesis:
The shape (depth and radius of curvature) of the articulating dish of a radial head prosthesis affects radiocapitellar stability.
Materials And Methods:
Radiocapitellar stability due to concavity-compression was evaluated in 8 fresh frozen elbows before and after radial head replacement with 2 different designs of radial head implants (RH 1 and RH 2). Both functioned as monopolar implants. Peak forces resisting subluxation and force-displacement characteristics were compared between the 2 and to the native radial head.
Results:
Radial head design significantly affected radiocapitellar stability. RH 1, which had a deeper dish than RH 2, required significantly higher peak forces to subluxate the radiocapitellar joint. The peak subluxation forces and the slopes of the force-displacement curves were not significantly different from the native radial head for RH 1, but they were for RH 2.
Conclusion:
The shape of the articular dish (depth, radius of curvature) of a monopolar radial head implant affects its contribution to radiocapitellar stability. An implant that mimics normal anatomy is more effective than a shallow radial head implant with a radius of curvature that is longer than normal.
