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Impact of Radiocapitellar Interposition Arthroplasty on Ulnohumeral Joint Biomechanics.

MedStar author(s):

Abbasi, Pooyan

, MUMH

, Orthopaedic Surgery Residency

Citation: Journal of Shoulder & Elbow Surgery. 2022 Oct 14PMID: 36252785Institution: MedStar Union Memorial HospitalDepartment: MedStar Georgetown University Hospital/MedStar Washington Hospital Center | Orthopaedic Surgery | Orthopaedic Surgery Residency | OrthopedicsForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: IN PROCESS -- NOT YET INDEXEDYear: 2022 ISSN:

1058-2746

Name of journal: Journal of shoulder and elbow surgeryAbstract: CONCLUSION: RCIA with a dermal graft reduced contact pressures within the ulnohumeral joint compared to radial head excision at 90degree of flexion without a significant change in contact area or contact force. Copyright © 2022. Published by Elsevier Inc.INTRODUCTION: Radial head excision has been shown to increase contact pressures within the ulnohumeral joint. Radiocapitellar interposition arthroplasty with the use of a soft tissue graft is an alternative for the treatment of isolated radiocapitellar arthritis or with failure of radial head replacement. We investigated contact pressures and contact area within the ulnohumeral joint after radial head excision (RHE) compared to radiocapitellar interposition arthroplasty with dermal autograft (RCIA).METHODS: Six fresh-frozen cadaver elbows were tested on a custom dynamic elbow frame. A pressure sensor was inserted into the intact elbow joint, and mean contact pressure, peak contact pressure, contact area, and force within the ulnohumeral joint were recorded at 0degree, 30degree, 60degree, 90degree, and 120degree of flexion as a valgus load was applied to the elbow. The radial head was then excised and specimens were retested. Finally, a dermal graft matched to the size of the resected radial head was inserted in the radiocapitellar space and the specimens were tested a third time.RESULTS: At 90degree of flexion, contact pressure within the ulnohumeral joint was significantly lower with RCIA compared with RHE (110.8 kPa vs. 216.8 kPa.; P = 0.013). Mean peak contact pressure was also significantly lower with RCIA compared with RHE at 90degree (279.4 vs. 626.7 kPa; P =0.025). No statistically significant differences were seen in mean contact area or force between the three testing conditions at any flexion position.All authors: Abbasi P, Ashmyan R, Carroll AH, Gillin TR, Murthi AM, Wright MAFiscal year: FY2023 Digital Object Identifier:

https://dx.doi.org/10.1016/j.jse.2022.09.008

Date added to catalog: 2022-10-27

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Title notes ( 5 )

Holdings
Item type	Current library	Collection	Call number	Status	Date due	Barcode
Journal Article	MedStar Authors Catalog	Article	36252785	Available		36252785

CONCLUSION: RCIA with a dermal graft reduced contact pressures within the ulnohumeral joint compared to radial head excision at 90degree of flexion without a significant change in contact area or contact force. Copyright © 2022. Published by Elsevier Inc.

INTRODUCTION: Radial head excision has been shown to increase contact pressures within the ulnohumeral joint. Radiocapitellar interposition arthroplasty with the use of a soft tissue graft is an alternative for the treatment of isolated radiocapitellar arthritis or with failure of radial head replacement. We investigated contact pressures and contact area within the ulnohumeral joint after radial head excision (RHE) compared to radiocapitellar interposition arthroplasty with dermal autograft (RCIA).

METHODS: Six fresh-frozen cadaver elbows were tested on a custom dynamic elbow frame. A pressure sensor was inserted into the intact elbow joint, and mean contact pressure, peak contact pressure, contact area, and force within the ulnohumeral joint were recorded at 0degree, 30degree, 60degree, 90degree, and 120degree of flexion as a valgus load was applied to the elbow. The radial head was then excised and specimens were retested. Finally, a dermal graft matched to the size of the resected radial head was inserted in the radiocapitellar space and the specimens were tested a third time.

RESULTS: At 90degree of flexion, contact pressure within the ulnohumeral joint was significantly lower with RCIA compared with RHE (110.8 kPa vs. 216.8 kPa.; P = 0.013). Mean peak contact pressure was also significantly lower with RCIA compared with RHE at 90degree (279.4 vs. 626.7 kPa; P =0.025). No statistically significant differences were seen in mean contact area or force between the three testing conditions at any flexion position.

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