Anatomic surface elbow arthroplasty. A preliminary report

Whereas loosening of the humeral component of the semiconstrained hinged prosthesis has been reported as one of the major long-term complications of this type of elbow arthroplasty, the major complication related to the use of a semiconstrained nonhinged prosthesis is apparently an increased incidence of long-term dislocation of the ulnar and humeral components. The author has attempted to overcome this problem by including a radial head component for routine use with a three-piece, nonconstrained surface prosthesis for elbow arthroplasty. The importance of the radial head as a transmitter of vertical loading forces across the elbow joint is stressed. The apparent function of the radial head as a primary bony stabilizer of the elbow against valgus stress forces is also described. In addition to the radial head innovation, the new prosthetic design allows for ligament balancing by use of a system of articulating polyethylene spacers snapped onto the ulnar and radial head components. Preliminary results in 13 cases, with a mean follow-up period of 18 months, are noted. Although the author's clinical series is small and the postoperative follow-up period is short, the concepts related to the use of a radial head component and the improved ligament balancing by use of polyethylene articulating spacers seem to be valid.