Intraoperative fluoroscopic assessment of proper prosthetic radial head height

H. Mike Kim, Evan P. Roush, Casey Kiser

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background Selecting a properly sized radial head prosthesis is imperative during radial head replacement. Although there has been much emphasis on avoiding overlengthening of the radius, little has been studied about how to avoid shortening. The purpose of this study was to characterize how a radial head replacement appears on intraoperative fluoroscopy depending on the height of the prosthetic radial head. Methods Articular cartilage thickness of the radial head was measured in 9 cadaveric elbows. Radial head replacement was performed in each specimen with 4 different prosthetic head heights: 4 mm and 2 mm shortening, anatomic, and 2 mm overlengthening. Anteroposterior fluoroscopic images were obtained for each head height, and the prosthetic radial head height was measured at 3 forearm positions (supination, neutral, and pronation) using the subchondral bone of the lateral edge of the coronoid at the reference point. Results The mean cartilage thickness of the radial head was 1.3 ± 0.4 mm. The prosthetic radial head appeared 2.2 ± 0.4 mm more proximal than the subchondral bone of the coronoid lateral edge in anteroposterior radiographs when the articular surface of the prosthesis was completely even with the coronoid articular surface. Unlike the native radial head, a prosthetic radial head showed a significant change of height with different forearm rotation (P < .001). Discussion This study found that a perfectly anatomic radial head replacement appears overlengthened by approximately 2 mm in intraoperative radiographs. This finding can be useful in guiding the appropriate height of a prosthetic radial head.

Original languageEnglish (US)
Pages (from-to)1874-1881
Number of pages8
JournalJournal of Shoulder and Elbow Surgery
Volume25
Issue number11
DOIs
StatePublished - Nov 1 2016

Fingerprint

Forearm
Prostheses and Implants
Joints
Head
Pronation
Supination
Bone and Bones
Fluoroscopy
Articular Cartilage
Elbow
Cartilage

All Science Journal Classification (ASJC) codes

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

@article{9c3038d403ec47f39a59057961011953,
title = "Intraoperative fluoroscopic assessment of proper prosthetic radial head height",
abstract = "Background Selecting a properly sized radial head prosthesis is imperative during radial head replacement. Although there has been much emphasis on avoiding overlengthening of the radius, little has been studied about how to avoid shortening. The purpose of this study was to characterize how a radial head replacement appears on intraoperative fluoroscopy depending on the height of the prosthetic radial head. Methods Articular cartilage thickness of the radial head was measured in 9 cadaveric elbows. Radial head replacement was performed in each specimen with 4 different prosthetic head heights: 4 mm and 2 mm shortening, anatomic, and 2 mm overlengthening. Anteroposterior fluoroscopic images were obtained for each head height, and the prosthetic radial head height was measured at 3 forearm positions (supination, neutral, and pronation) using the subchondral bone of the lateral edge of the coronoid at the reference point. Results The mean cartilage thickness of the radial head was 1.3 ± 0.4 mm. The prosthetic radial head appeared 2.2 ± 0.4 mm more proximal than the subchondral bone of the coronoid lateral edge in anteroposterior radiographs when the articular surface of the prosthesis was completely even with the coronoid articular surface. Unlike the native radial head, a prosthetic radial head showed a significant change of height with different forearm rotation (P < .001). Discussion This study found that a perfectly anatomic radial head replacement appears overlengthened by approximately 2 mm in intraoperative radiographs. This finding can be useful in guiding the appropriate height of a prosthetic radial head.",
author = "Kim, {H. Mike} and Roush, {Evan P.} and Casey Kiser",
year = "2016",
month = "11",
day = "1",
doi = "10.1016/j.jse.2016.04.014",
language = "English (US)",
volume = "25",
pages = "1874--1881",
journal = "Journal of Shoulder and Elbow Surgery",
issn = "1058-2746",
publisher = "Mosby Inc.",
number = "11",

}

Intraoperative fluoroscopic assessment of proper prosthetic radial head height. / Kim, H. Mike; Roush, Evan P.; Kiser, Casey.

In: Journal of Shoulder and Elbow Surgery, Vol. 25, No. 11, 01.11.2016, p. 1874-1881.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Intraoperative fluoroscopic assessment of proper prosthetic radial head height

AU - Kim, H. Mike

AU - Roush, Evan P.

AU - Kiser, Casey

PY - 2016/11/1

Y1 - 2016/11/1

N2 - Background Selecting a properly sized radial head prosthesis is imperative during radial head replacement. Although there has been much emphasis on avoiding overlengthening of the radius, little has been studied about how to avoid shortening. The purpose of this study was to characterize how a radial head replacement appears on intraoperative fluoroscopy depending on the height of the prosthetic radial head. Methods Articular cartilage thickness of the radial head was measured in 9 cadaveric elbows. Radial head replacement was performed in each specimen with 4 different prosthetic head heights: 4 mm and 2 mm shortening, anatomic, and 2 mm overlengthening. Anteroposterior fluoroscopic images were obtained for each head height, and the prosthetic radial head height was measured at 3 forearm positions (supination, neutral, and pronation) using the subchondral bone of the lateral edge of the coronoid at the reference point. Results The mean cartilage thickness of the radial head was 1.3 ± 0.4 mm. The prosthetic radial head appeared 2.2 ± 0.4 mm more proximal than the subchondral bone of the coronoid lateral edge in anteroposterior radiographs when the articular surface of the prosthesis was completely even with the coronoid articular surface. Unlike the native radial head, a prosthetic radial head showed a significant change of height with different forearm rotation (P < .001). Discussion This study found that a perfectly anatomic radial head replacement appears overlengthened by approximately 2 mm in intraoperative radiographs. This finding can be useful in guiding the appropriate height of a prosthetic radial head.

AB - Background Selecting a properly sized radial head prosthesis is imperative during radial head replacement. Although there has been much emphasis on avoiding overlengthening of the radius, little has been studied about how to avoid shortening. The purpose of this study was to characterize how a radial head replacement appears on intraoperative fluoroscopy depending on the height of the prosthetic radial head. Methods Articular cartilage thickness of the radial head was measured in 9 cadaveric elbows. Radial head replacement was performed in each specimen with 4 different prosthetic head heights: 4 mm and 2 mm shortening, anatomic, and 2 mm overlengthening. Anteroposterior fluoroscopic images were obtained for each head height, and the prosthetic radial head height was measured at 3 forearm positions (supination, neutral, and pronation) using the subchondral bone of the lateral edge of the coronoid at the reference point. Results The mean cartilage thickness of the radial head was 1.3 ± 0.4 mm. The prosthetic radial head appeared 2.2 ± 0.4 mm more proximal than the subchondral bone of the coronoid lateral edge in anteroposterior radiographs when the articular surface of the prosthesis was completely even with the coronoid articular surface. Unlike the native radial head, a prosthetic radial head showed a significant change of height with different forearm rotation (P < .001). Discussion This study found that a perfectly anatomic radial head replacement appears overlengthened by approximately 2 mm in intraoperative radiographs. This finding can be useful in guiding the appropriate height of a prosthetic radial head.

UR - http://www.scopus.com/inward/record.url?scp=84977667281&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84977667281&partnerID=8YFLogxK

U2 - 10.1016/j.jse.2016.04.014

DO - 10.1016/j.jse.2016.04.014

M3 - Article

C2 - 27364146

AN - SCOPUS:84977667281

VL - 25

SP - 1874

EP - 1881

JO - Journal of Shoulder and Elbow Surgery

JF - Journal of Shoulder and Elbow Surgery

SN - 1058-2746

IS - 11

ER -