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Stress shielding around radial head prostheses.

Cholawish Chanlalit1, Dave R Shukla, James S Fitzsimmons

  • 1Biomechanics Laboratory, Department of Orthopedic Surgery, Mayo Clinic, Rochester MN, USA.

The Journal of Hand Surgery
|October 2, 2012
PubMed
Summary
This summary is machine-generated.

Stress shielding is common around radial head prostheses but typically minor and nonprogressive. This radiographic finding has questionable clinical significance, regardless of implant design.

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Area of Science:

  • Orthopedic surgery
  • Biomedical engineering
  • Radiology

Background:

  • Stress shielding is a known complication of rigidly fixed implants.
  • Its prevalence and progression around radial head prostheses require further investigation.

Purpose of the Study:

  • To investigate the incidence and progression of stress shielding around radial head prostheses.
  • To develop a classification scheme for radiographic observations of stress shielding.

Main Methods:

  • Retrospective review of 86 radial head implant cases (79 patients).
  • Exclusion of cases with infection, loosening, or <12 months follow-up.
  • Classification of stress shielding into stages: I (cortical thinning), II (exposed stem), and III (impending failure).

Main Results:

  • Stress shielding was observed in 63% (17/26) of well-fixed stems.
  • It occurred with all stem types and was less common with radial shaft placement.
  • Bone loss was typically minor, nonprogressive, and did not lead to mechanical failure.

Conclusions:

  • Stress shielding is a common radiographic finding around radial head prostheses.
  • It is generally minor, nonprogressive, and of questionable clinical consequence.
  • Implant design does not significantly influence the occurrence of stress shielding.