Contact analysis of the native radiocapitellar joint compared with axisymmetric and nonaxisymmetric radial head hemiarthroplasty

Journal of Shoulder and Elbow Surgery
G Daniel G LangohrJ A Johnson

Abstract

Radial head (RH) implants are manufactured from stiff materials, resulting in reduced radiocapitellar contact area that may lead to cartilage degeneration. Although the native RH is nonaxisymmetric, most implants are axisymmetric, potentially contributing to altered contact mechanics. This study compared the joint contact area (Ac) and maximum contact stress (σmax) of axisymmetric and nonaxisymmetric RH implants to the native radiocapitellar joint. The contact mechanics of intact elbows derived from cadaveric computed tomography data (n = 15) were compared with axisymmetric (size: 18, 20, 22 mm) and nonaxisymmetric (size: 16 × 18, 18 × 20, 20 × 22 mm) RH hemiarthroplasty reconstructed elbows using Abaqus finite element software. Under a 100 N load, Ac and σmax were computed for ±90° pronation-supination and 0°, 45°, 90°, and 135° flexion. Compared with native, both hemiarthroplasty models produced significantly lower Ac and higher σmax (P < .001). In the best orientation, the nonaxisymmetric RH provided significantly larger Ac at 0° and 135° flexion (P = .03, P = .007) and reduced levels of σmax at 45° and 90° flexion (P = .003, P < .001). However, there was also a worst orientation that reduced Ac and increased σmax for all fl...Continue Reading

References

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Citations

Oct 24, 2015·Journal of Biomechanics·Ryan WillingJames A Johnson
Jun 1, 2016·The Journal of Hand Surgery·G Daniel G LangohrJames A Johnson
Aug 8, 2018·Journal of Orthopaedic Trauma·Daniel R BachmanShawn W O'Driscoll
Feb 13, 2019·The Journal of Hand Surgery, European Volume·Yucheng SunIn-Ho Jeon
Jun 22, 2017·Annual Review of Biomedical Engineering·Steve A MaasJeffrey A Weiss
Oct 9, 2019·Journal of Orthopaedic Research : Official Publication of the Orthopaedic Research Society·Chalotte K HemmingsenMaiken Stilling
Feb 6, 2020·Journal of Orthopaedic Research : Official Publication of the Orthopaedic Research Society·Carolyn BerkmortelJames Johnson
Oct 20, 2018·Journal of Orthopaedic Trauma·Daniel R BachmanShawn W OʼDriscoll
Aug 28, 2020·Indian Journal of Orthopaedics·Davide CucchiUNKNOWN ESSKA Elbow and Wrist Committee 2016–2018
Jun 22, 2021·Journal of Clinical Orthopaedics and Trauma·Christopher P JukesJoideep Phadnis

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