The biomechanical effect of prosthetic design on radiocapitellar stability in a terrible triad model

Cholawish Chanlalit, Dave R. Shukla, James S. Fitzsimmons, Kai Nan An, Shawn W. O'Driscoll

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)539-544
Number of pages6
JournalJournal of Orthopaedic Trauma
Volume26
Issue number9
DOIs
StatePublished - Sep 2012

Fingerprint

Prostheses and Implants
Elbow
Elbow Prosthesis
Wounds and Injuries
Joints
Fracture Dislocation

Keywords

  • elbow
  • fracture
  • instability
  • prosthesis
  • radial head replacement
  • terrible triad injury

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

The biomechanical effect of prosthetic design on radiocapitellar stability in a terrible triad model. / Chanlalit, Cholawish; Shukla, Dave R.; Fitzsimmons, James S.; An, Kai Nan; O'Driscoll, Shawn W.

In: Journal of Orthopaedic Trauma, Vol. 26, No. 9, 09.2012, p. 539-544.

Research output: Contribution to journalArticle

Chanlalit, Cholawish ; Shukla, Dave R. ; Fitzsimmons, James S. ; An, Kai Nan ; O'Driscoll, Shawn W. / The biomechanical effect of prosthetic design on radiocapitellar stability in a terrible triad model. In: Journal of Orthopaedic Trauma. 2012 ; Vol. 26, No. 9. pp. 539-544.
@article{5bfc2380ea324b16b599b3cae1e3fef1,
title = "The biomechanical effect of prosthetic design on radiocapitellar stability in a terrible triad model",
abstract = "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.",
keywords = "elbow, fracture, instability, prosthesis, radial head replacement, terrible triad injury",
author = "Cholawish Chanlalit and Shukla, {Dave R.} and Fitzsimmons, {James S.} and An, {Kai Nan} and O'Driscoll, {Shawn W.}",
year = "2012",
month = "9",
doi = "10.1097/BOT.0b013e318238b3a2",
language = "English (US)",
volume = "26",
pages = "539--544",
journal = "Journal of Orthopaedic Trauma",
issn = "0890-5339",
publisher = "Lippincott Williams and Wilkins",
number = "9",

}

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.

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.

KW - elbow

KW - fracture

KW - instability

KW - prosthesis

KW - radial head replacement

KW - terrible triad injury

UR - http://www.scopus.com/inward/record.url?scp=84865776600&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84865776600&partnerID=8YFLogxK

U2 - 10.1097/BOT.0b013e318238b3a2

DO - 10.1097/BOT.0b013e318238b3a2

M3 - Article

C2 - 22377508

AN - SCOPUS:84865776600

VL - 26

SP - 539

EP - 544

JO - Journal of Orthopaedic Trauma

JF - Journal of Orthopaedic Trauma

SN - 0890-5339

IS - 9

ER -