Radial head replacement (literature review)
Keywords:radial head, monoblocal and bipolar endoprosthesis
On the basis of the literature analysis, various variants of the radial head endoprostheses, which were used earlier and are now used in clinical practice, are considered: monobloc, individual monobloc, sectional modular monobloc, bipolar modular. The generally accepted classification of endoprostheses does not exist for the radial head — today they are distributed by design to monoblocal and bipolar. Monoblocal endoprosthesis can be either modular or sectional. Bipolar radial head endoprosthesis has joint between the implant head and the leg of the hinge node, an additional degree of freedom in which provides the maximum congruent location of the head of the endoprosthesis during flexsion, extension and rotation of the radius in the elbow joint. The biomechanical peculiarities of the functioning of different types of endoprostheses are determined, sort-term and long-term clinical results of their application are shown. The indications for radial head replacement are: the lack of technical ability to perform internal fixation of Mason-Hotchkiss types III and IV injuries, as well as in the case of additional destabilizing disorders of the capsule-ligamentous apparatus, Essex-Loprest type injury, and instability of the elbow and/or pain in the arm after radial head resection, its unsatisfactory osteosynthesis, tumors of the proximal radius. The authors claim that in case of use of metallic endoprostheses, the radial head restores the valgus stability of the elbow to the normal level. From the first radial head replacement has passed over than 75 years, and the search for an ideal endoprosthesis is relevant. Despite the large number of designs and types of endoprosthesis, there is currently no implant that works as a natural radial head. All technological improvements are aimed at increasing the life of implants and minimizing injuries to the cartilage and soft tissues both during installation and in the process of work.
Calfee R, Madom I, Weiss AP. Weiss Radial head arthroplasty. J Hand Surg Am. 2006;31(2):314–21. doi: 10.1016/j.jhsa.2005.12.005.
Chantelot C, Wavreille G. Radial head fractures: Treatment by prosthetic replacement. Orthop Traumatol Surg Res. 2009;95(6):458–61. doi: 10.1016/j.otsr.2009.07.001.
Jackson JD, Steinmann SP. Radial head fractures. Hand Clin. 2007;23(2):185–93. doi: 10.1016/j.hcl.2007.01.009.
Pike JM, Athwal GS, Faber KJ, King GJ. Radial head fractures-an update. J Hand Surg Am. 2009;34(3):557–65. doi: 10.1016/j.jhsa.2008.12.024.
Ring D. Displaced, unstable fractures of the radial head: fixation vs. replacement--what is the evidence? Injury. 2008;39(12):1329–37. doi: 10.1016/j.injury.2008.04.011.
Mason M. Some observations on fractures of the head of the radius with a review of one hundred cases. Br J Surg. 1954;42:123–32.
Sheehan SE, Dyer GS, Sodickson AD, Patel KI, Khurana B. Traumatic elbow injuries: what the orthopedic surgeon wants to. Radiographics. 2013;33(3):869–88. doi: 10.1148/rg.333125176.33(3):869-888.
Johnston GW. A follow-up of one hundred cases of fracture of the head of the radius with a review of the literature. Ulster Med J. 1962;31:51–6.
Hotchkiss RN. Displaced fractures of the radial head: internal fixation or excision? J Am Acad Orthop Surg. 1997;5:1–10.
Muller ME, Nazarian S, Koch P, Schatzker J. The comprehensive classification of fractures in long bones. Berlin: Springer-Verlag; 1990. 202 p. doi: 10.1007/978-3-642-61261-9.
Clembosky G, Boretto JG. Open reduction and internal fixation versus prosthetic replacement for complex fractures of the radial head. J Hand Surg Am. 2009;34(6):1120–3. doi: 10.1016/j.jhsa.2008.12.031.
Dodds SD, Yeh PC, Slade 3rd JF. Essex-lopresti injuries. Hand Clin. 2008;24(1):125–37. doi: 10.1016/j.hcl.2007.11.009.
Doornberg JN, Parisien R, van Duijn PJ, Ring D. Radial head arthroplasty with a modular metal spacer to treat acute traumatic elbow instability. J Bone Joint Surg Am. 2007;89(5):1075–80. doi: 10.2106/JBJS.E.01340.
Speed K. Ferrule cups for the head of the radius. Surg Gynecol Obstet. 1941;73:845–50.
Creyssel J, de Morgues G. Résection de la teteradiale avec endhoprothèseen nylon. Lyon Chir. 1951;46:508.
Cherry JC. Use of acrylic prosthesis in the treatment of fracture of the head of the radium. J Bone Joint Surg Br. 1953;35:70–1.
Albonico P. Endoprotesi in Vitallium in sostituzione del capitello radiale asportato per frattura. Chir Org Mov. 1953;XXXVII:134–43.
Swanson AB, Jaeger SH, La Rochelle D. Comminuted fractures of the radial head. J Bone Joint Surg Am. 1981;63:1039–49.
Mackay I, Fitzgerald B, Miller JH. Silastic replacement of the head of the radius in trauma. J Bone Joint Surg Br. 1979;61-B(4):494–7.
Morrey BF, Askew L, Chao EY. Silastic prosthetic replacement for the radialhead. J Bone Joint Surg Am. 1981;63(3):454–8.
Vanderwilde RS, Morrey BF, Melberg MW, Vinh TN. Inflammatory arthritis after failure of silicone rubberreplacement of the radial head. J Bone Joint Surg Br. 1994;76(1):78–81.
Carn RM, Medige J, Curtain D, Koenig A. Silicone rubber replacement of the severely fractured radial head. Clin Orthop Relat Res. 1986;209:259–69.
Stoffelen DV, Holdsworth BJ. Excision or Silastic replacement for comminuted radial head fractures. A long-term follow-up. Acta Orthop Belg. 1994;60(4):402–7.
Dudko GE. Endoprosthetics of the radial head and neck. Moscow: Medicine, 1991. 124 p. (in Russian)
Movshovich IA, Voskresenskiĭ GL, Gavriushenko NS, Selia LSh. Replacement of the radial head with a silicone implant. Orthopedics, traumatology and prosthetics. 1986;(8):12–5. (in Russian)
Ring D, King G. Radial head arthroplasty with a modular metal spacer to treat acute traumatic elbow instability. Surgical technique. J Bone Joint Surg Am. 2008;90 Suppl 2 Pt 1:63–73. doi: 10.2106/JBJS.G.01248.
Ruan HJ, Fan CY, Liu JJ, Zeng BF. A comparative study of internal fixation and prosthesis replacement for radial head fractures of Mason type III Int Orthop. 2009;33(1):249–53. doi: 10.1007/s00264-007-0453-3.
Stuffmann E, Baratz ME. Radial head implant arthroplasty. J Hand Surg Am. 2009;34(4):745–54. doi: 10.1016/j.jhsa.2009.01.027.
Tejwani NC, Mehta H. Fracture of the radial head and neck: current concepts in management. J Am Acad Orthop Surg. 2007;15(7):380–7.
Popovic N, Lemaire R, Georis P, Gillet P. Midterm results with a bipolar radial head prosthesis: radiographic evidence of loosening at the bone-cement interface. J Bone Joint Surg Am. 2007;89(11):2469–76. doi: 10.2106/JBJS.F.00723.
Pomianowski S, Morrey BF, Neale PG, Park MJ, O'Driscoll SW, An KN. Contribution of monoblock and bipolar radial head prostheses to valgus stability of the elbow. J Bone Joint Surg Am. 2001;83-A(12):1829–34.
Knight DJ, Rymaszewski LA, Amis AA, Miller JH. Primary replacement of the fractured radial head with a metal prosthesis. J Bone Joint Surg Br. 1993;75-B:572–6.
Seitz WH Jr., Santilli AN. Pat. US 8353965 B2. Small joint orthopedic implants and their manufacture. Available from: https://www.google.ch/patents/US8353965?dq=ininventor:%22William+H.+Seitz,+Jr.%22&hl=en&sa=X&ved=0ahUKEwi7xoLDi9DWAhXEJJoKHavzDFgQ6AEIJTA.
Grewal R, MacDermid JC, Faber KJ, Drosdowech DS, King GJ. Comminuted radial head fractures treated with a modular metallic radial head arthroplasty. J Bone Joint Surg. 2006;88(10):2192–200. doi: 10.2106/JBJS.E.00962.
Loskutov OE, Zherdev II , Makarov VB, et al. Endoprosthetics of the radial head. Orthopedics, traumatology and prosthetics. 2004;3:107–11. (in Russian)
Loskutov OE, Zherdev II, Krasovsky VL, Makarov VB. Patent 10903 U UA, IPC (2006) A61F 2/38. Modular endoprosthetic of the radila head. No. 20041109182; 09.11.2004; 15.12.2005, Bul. No 12.
Abdulla IN, Molony DC, Symes M, Cass B. Radial head replacement with pyrocarbon prosthesis: early clinical results. ANZ J Surg. 2014;85(5):368–72. doi: 10.1111/ans.12908.
Marsh JP, Grewal R, Faber KJ, Drosdowech DS, Athwal GS, King GJ. Radial head fractures treated with modular metallic radial head replacement: outcomes at a mean follow-up of eight years. J Bone Joint Surg Am. 2016;98(7):527–35. doi: 10.2106/ JBJS.15.00128.
Moro JK, Werier J, MacDermid JC, Patterson SD, King GJ. Arthroplasty with a metal radial head for unreconstructible fractures of the radial head. J Bone Joint Surg Am. 2001;83-A(8):1201–11.
Hartzler RU, Morrey BF, Steinmann SP, Llusa-Perez M, Sanchez-Sotelo J. Radial head reconstruction in elbow fracture-dislocation monopolar or bipolar prosthesis? Clin Orthop Relat Res. 2014;472(2):2144–50. doi: 10.1007/s11999-014-3672-0.
Athwal GS, Frank SG, Grewal R, Faber KJ, Johnson J, King GJ. Determination of correct implant size in radial head arthroplasty to avoid overlengthening: surgical technique. J Bone Joint Surg Am. 2010;92 Suppl 1 Pt 2:250–7. doi: 10.2106/JBJS.J.00356.
Berschback JC, Lynch TS, Kalainov DM, Wysocki RW, Merk BR, Cohen MS. Clinical and radiographic comparisons of two different radial head implant designs. J Shoulder Elbow Surg. 2013;22(8):1108–20. doi: 10.1016/j.jse.2013.02.011.
Burkhart KJ, Mattyasovszky SG, Runkel M, Schwarz C, Küchle R, Hessmann MH, Rommens PM, Lars MP. Mid- to long-term results after bipolar radial head arthroplasty. J Shoulder Elbow Surg. 2010;19:965–72. doi: 10.1016/j.jse.2010.05.022.
Dotzis A, Cochu G, Mabit C, Charissoux JL, Arnaud JP Comminuted fractures of the radial head treated by the Judet floating radial head prosthesis. J Bone Joint Surg Br. 2006;88(6):760–4. doi: 10.1302/0301-620X.88B6.17415
Judet T, Garreau de Loubresse C, Piriou P, Charnley G. A floating prosthesis for radial-head fractures. J Bone Joint Surg. 1996;78-B:244–9.
Judet T, Massin P, Bayeh PJ. Prothèse de tête radiale à cupule flottantedans les traumatismesrécentsetanciens du coude: Résultatspréliminaires. Rev Chir Orthop Traumatol. 1994;80(2):123–30. doi: RCO-04-1994-80-2-0035-1040-101019-ART55.
Herald J, O'Driscoll S. Complete dissociation of a bipolar radial head prosthesis: acase report. J Shoulder Elbow Surg. 2008;17(6):e22–3. doi: 10.1016/j.jse.2008.02.020.
Smets S, Govaers K, Jansen N, Van Riet R, Schaap M, Van Glabbeek F. Floating radial head prosthesis for comminuted radial head fractures: a multicentric study. Acta Orthop Belg. 2000;66(4):353–8.
Popovic N, Djekic J, Lemaire R, Gillet P. A comparative study between proximal radial morphology and the floating radial head prosthesis. J Shoulder Elbow Surg. 2005;14(4):433–40. doi: 10.1016/j.jse.2004.10.012.
Allavena C, Delclaux S, Bonnevialle N, Rongières M, Bonnevialle P, Mansat P. Outcomes of bipolar radial head prosthesis to treat complex radial head fractures in 22 patients with a mean follow-up of 50 months. Orthop Traumatol Surg Res. 2014;100(7):703–9. doi: 10.1016/j.otsr.2014.06.019.
Skalski K, Swieszkowski W, Pomianowski S, Kedzior K, Kowalik S. Radial head prosthesis with a mobile head. J. Shoulder Elbow Surg. 2004;13(1):78–85. doi: 10.1016/S105827460300257X.
Swieszkowski W, Skalski K, Pomianowski S, Kedzior K. The anatomic features of the radial head and their implication for prosthesis design. Clin Biomech. 2001;16(10):880–7.
Kang SH, Kim DY, Park H, Song HS. Anthropometric study of the proximal radius: does radial head implant fit in all cases. Int Orthop. 2015;39(8):1553–61. doi: 10.1007/s00264-015-2773-z.
Zwingmann J, Bode G, Hammer T, Südkamp NP, Strohm PC. Radialhead prosthesis afterradialhead and neck fractures — current literature and quality of evidence. Acta Chir Orthop Traumatol. Cech. 2015;82(3):177–85.
Harrington IJ, Sekyi-Otu A, Barrington TW, Evans DC, Tuli V. The functional outcome with metallic radial head implants in the treatment of unstable elbow fractures: a long-term review. J Trauma. 2001;50(1):46–52.
Lim YJ, Chan BK. Short-term to medium-term outcomes of cemented Vitallium radial head prostheses after early excision for radial head fractures. J Shoulder Elbow Surg. 2008;17(2):307–32. doi: 10.1016/j.jse.2007.07.020.
Chien HY, Chen AC, Huang JW, Cheng CY, Hsu KY. Short- to medium-term outcomes of radial head replacementarthroplasty in posttraumatic unstable elbows: 20 to 70 months follow-up. Chang Gung Med J. 2010;33(6):668–78.
Brinkman JM, Rahusen FT, de Vos MJ, Eygendaal D. Treatment of sequelae of radial head fractures with a bipolar radial head prosthesis: good outcome after 1–4 years follow-up in 11 patients. Acta Orthop. 2005;76(6):867–72. doi:10.1080/17453670510045516.
Burkhart KJ, Mattyasovszky SG, Runkel M, Schwarz C, Küchle R, Hessmann MH, Rommens PM, Lars MP. Mid- to long-term results after bipolar radial head arthroplasty. J Shoulder Elbow Surg. 2010;19(7):965–72. doi: 10.1016/j.jse.2010.05.022.
Jensen SL, Olsen BS, Tyrdal S, Søjbjerg JO, Sneppen O. Elbow joint laxity after experimental radial head excision and lateral collateral ligament rupture: Efficacy of prosthetic replacement and ligament repair. J. Shoulder Elbow Surg. 2005;1491):78–84. doi: 10.1016/j.jse.2004.05.009.
Johnson JA, Beingessner DM, Gordon KD, Dunning CE, Stacpoole RA, King GJ. Kinematics and stability of the fractured and implantreconstructed radial head. J Shoulder Elbow Surg. 2005; 14(1 Suppl S):195S-201S. doi: 10.1016/j.jse.2004.09.034.
King GJ, Zarzour ZD, Rath DA, Dunning CE, Patterson SD, Johnson JA. Metallic radial head arthroplasty improves valgus stability of the elbow. Clin Orthop. 1999;(368):114–25.
Orbay JL, Mijares MR, Berriz CG. The transverse force experienced by the radial head during axial loading of the forearm: A cadaveric study. Clin Biomech. 2016;31:117–22. doi: 10.1016/j.clinbiomech.2015.10.007.
van Riet RP, Van Glabbeek F, Baumfeld JA, Neale PG, Morrey BF, O'Driscoll SW, An KN. The effect of the orientation of the non-circular radial head on elbow kinematics. Clin Biomech 2004;19(6):595–9. doi: 10.1016/j.clinbiomech.2004.03.002.
Schneeberger AG, Sadowski MM, Jacob HA. Coronoid process and radial head as posterolateral rotatory stabilizers of the elbow. J Bone Joint Surg Am. 2004;86-A(5):975–82.
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