TY - JOUR
T1 - The biomechanical effect of prosthetic design on radiocapitellar stability in a terrible triad model
AU - Chanlalit, Cholawish
AU - Shukla, Dave R.
AU - Fitzsimmons, James S.
AU - An, Kai Nan
AU - O'Driscoll, Shawn W.
N1 - Copyright:
Copyright 2013 Elsevier B.V., All rights reserved.
PY - 2012/9
Y1 - 2012/9
N2 - OBJECTIVES: The integrity of elbow soft tissues affects radiocapitellar joint stability in the presence of bipolar radial head (RH) prostheses. This study examined the effect on radiocapitellar stability of monopolar designs versus bipolar RH prostheses in an elbow model with a surgically controlled terrible triad injury. METHODS: In each of 8 fresh-frozen elbow specimens (4 male and 4 female), a terrible triad fracture dislocation was created through soft tissue releases, coronoid fracture, and RH resection. Radiocapitellar stability was recorded under the following 3 sets of conditions: (1) surgical control (native RH), (2) RH replacement (circular monopolar or bipolar), (3) replacement with alternate circular RH not used in condition 2, and (4) replacement with the anatomic RH. RESULTS: The type of RH used significantly impacted the mean peak force required to resist posterior subluxation (p = 0.0001). The mean peak subluxation force of the bipolar prosthesis (1 ± 1 N) was significantly less than both the anatomic (16 ± 1 N) and nonanatomic circular (12 ± 1 N) implants (p = 0.0002). The peak subluxation force of the native RH (18 ± 2 N) was not different than the anatomic implant (p = 0.09) but was greater than the nonanatomic circular design (p = 0.0006). CONCLUSIONS: Monopolar RHs confer greater radiocapitellar stability than bipolar implants in the setting of terrible triad injuries. Of the 2 monopolar designs tested, the anatomic design provided more stability than the non-anatomic RH prosthesis.
AB - OBJECTIVES: The integrity of elbow soft tissues affects radiocapitellar joint stability in the presence of bipolar radial head (RH) prostheses. This study examined the effect on radiocapitellar stability of monopolar designs versus bipolar RH prostheses in an elbow model with a surgically controlled terrible triad injury. METHODS: In each of 8 fresh-frozen elbow specimens (4 male and 4 female), a terrible triad fracture dislocation was created through soft tissue releases, coronoid fracture, and RH resection. Radiocapitellar stability was recorded under the following 3 sets of conditions: (1) surgical control (native RH), (2) RH replacement (circular monopolar or bipolar), (3) replacement with alternate circular RH not used in condition 2, and (4) replacement with the anatomic RH. RESULTS: The type of RH used significantly impacted the mean peak force required to resist posterior subluxation (p = 0.0001). The mean peak subluxation force of the bipolar prosthesis (1 ± 1 N) was significantly less than both the anatomic (16 ± 1 N) and nonanatomic circular (12 ± 1 N) implants (p = 0.0002). The peak subluxation force of the native RH (18 ± 2 N) was not different than the anatomic implant (p = 0.09) but was greater than the nonanatomic circular design (p = 0.0006). CONCLUSIONS: Monopolar RHs confer greater radiocapitellar stability than bipolar implants in the setting of terrible triad injuries. Of the 2 monopolar designs tested, the anatomic design provided more stability than the non-anatomic RH prosthesis.
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U2 - 10.1097/BOT.0b013e318238b3a2
DO - 10.1097/BOT.0b013e318238b3a2
M3 - Article
C2 - 22377508
AN - SCOPUS:84865776600
SN - 0890-5339
VL - 26
SP - 539
EP - 544
JO - Journal of Orthopaedic Trauma
JF - Journal of Orthopaedic Trauma
IS - 9
ER -