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Does stress shielding after radial head arthroplasty affect functional outcomes?

Ho-Jae Lee1, Byung-Kook Kim1, Suk-Han Jung1

  • 1Department of Orthopaedic Surgery, Gumi CHA Medical Center, CHA University School of Medicine, Sinsi-ro 10gil 12, Gumi-si, Kyungsangbuk-do, 39314, Republic of Korea.

European Journal of Orthopaedic Surgery & Traumatology : Orthopedie Traumatologie
|June 28, 2022
PubMed
Summary

Stress shielding after radial head arthroplasty (RHA) occurred in 40% of patients, particularly with anatomical press-fit designs and ligament injuries. This phenomenon did not impact mid-term clinical outcomes.

Keywords:
Radial head arthroplastyRadial head fracturesStress shielding

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Area of Science:

  • Orthopedic surgery
  • Biomaterials science
  • Radiology

Background:

  • Radial head arthroplasty (RHA) can lead to complications like stress shielding.
  • Stress shielding is a known issue with rigidly fixed implants.

Purpose of the Study:

  • To evaluate the clinical influence of stress shielding after RHA.
  • To identify causative factors of stress shielding in RHA.

Main Methods:

  • Retrospective review of 35 patients undergoing RHA for unreconstructable radial head fractures.
  • Comparison between anatomical press-fit and cemented bipolar designs.
  • Radiological assessment of stress shielding and clinical outcomes (MEPS, q-DASH, ROM, VAS).

Main Results:

  • Stress shielding was observed in 40% of patients at an average follow-up of 43 months.
  • Higher rates of stress shielding were associated with bilateral ligament injury and anatomical press-fit implants (p<0.05).
  • Stress shielding did not significantly affect mid-term clinical outcomes (p>0.05).

Conclusions:

  • Prosthetic design and ligament injury severity influence stress shielding in RHA.
  • Stress shielding around radial head prostheses does not negatively impact mid-term functional results for acute fractures.