Stem diameter and micromotion of press fit radial head prosthesis: A biomechanical study

Moon, Jun Gyu; Berglund, Lawrence J.; Domire, Zachary J.; An, Kai Nan; O’Driscoll, Shawn W.

doi:10.1016/j.jse.2009.02.014

Cited by 50 publications

(40 citation statements)

References 17 publications

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“…Prosthetic tip micromotion was measured with a custom-made device previously reported by Moon et al 11 A metal plate (6.5 mm thick and 100 mm in diameter) was fitted around the radial head stem. This plate-specimen construct was rigidly fixed in the machine.…”

Section: Testing Micromotionmentioning

confidence: 99%

Effect of hoop stress fracture on micromotion of textured ingrowth stems for radial head replacement

Chanlalit

Shukla

Fitzsimmons

et al. 2012

Journal of Shoulder and Elbow Surgery

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Section: Testing Micromotionmentioning

confidence: 99%

Effect of hoop stress fracture on micromotion of textured ingrowth stems for radial head replacement

Chanlalit

Shukla

Fitzsimmons

et al. 2012

Journal of Shoulder and Elbow Surgery

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“…The effects of several aspects of prosthetic radial head stems have been studied, including the type and extent of surface coating [8,12], stem diameter [9] and stem length [13]. Studies have shown that the amount of energy required to fully insert the rasp and stem can be used as a guide to assess the appropriateness of implant diameter [7,8,11].…”

Section: Discussionmentioning

confidence: 99%

“…Implants were inserted using a previously described customised slap hammer [7,8,11]. The removable weights (0.5, 0.75 and 1 kg) and height options from which the weight was dropped (0.1 or 0.15 m) allowed for quantification of the kinetic energy required for rasp and stem insertion.…”

Section: Kinetic Energy Measurementsmentioning

confidence: 99%

“…Micromotion was measured using a previously reported device [7,12,13]. Following stem insertion, a metal dish (10 mm thickness, 100 mm diameter) was secured around the top of the radial head and locked with a screw.…”

Section: Micromotion Testingmentioning

confidence: 99%

“…Micromotion in excess of 100∼150 μm impairs osseous interdigitation and results in fibrous tissue formation [5,6]. Several recent biomechanical studies have highlighted the correlation between prosthetic stem diameter and micromotion [7][8][9]. Specifically, maximising the stem diameter tends to minimise implant micromotion.…”

Section: Introductionmentioning

confidence: 99%

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Prosthetic radial head stem pull-out as a mode of failure: a biomechanical study

Shukla

Fitzsimmons

et al. 2013

International Orthopaedics (SICOT)

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Purpose Press-fit cementless radial head implant longevity relies on adequate bone ingrowth. Failed implant osseointegration remains a clinical concern and has been shown to lead to prosthetic failure. The purpose of this study was to test the hypothesis that implants with sufficient initial press-fit stability would be less likely to fail due to implant pull-out, as demonstrated by an increasing amount of energy required to remove the prosthesis from the canal. Methods Ten cadaveric radii were implanted with five sizes (6-10 mm in 1-mm increments) of grit-blasted, cementless radial head stems. A customised slap hammer was used to measure the energy required to remove each stem. Stem-bone micromotion was also measured. Results The suboptimally sized stem (Max − 1) (i.e. 1 mm undersized) required less energy (0.5±0 J) to pull out than the optimally sized stem (Max) (1.7±0.3 J) (p =0.008). The optimally sized stem demonstrated greater initial stability (45±7 μm) than the suboptimally sized stem (79±12 μm) (p =0.004). Conclusions This investigation demonstrates the importance of obtaining adequate press-fit stability for the prevention of radial head stem pull-out failure. These data add to the relatively scant knowledge in the literature regarding radial head biomechanics. The energy required to remove a prosthetic radial head ingrowth stem decreases in conjunction with diameter. The use of an inadequately sized stem increases the stem's micromotion as well as the risk of prosthetic loosening due to pull-out.

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Anatomical Monopolar Press-Fit Radial Head Arthroplasty: Surgical Technique and Expected Outcomes

Marinelli

Shukla

2019

Elbow Arthroplasty

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Stem diameter and micromotion of press fit radial head prosthesis: A biomechanical study

Cited by 50 publications

References 17 publications

Effect of hoop stress fracture on micromotion of textured ingrowth stems for radial head replacement

Effect of hoop stress fracture on micromotion of textured ingrowth stems for radial head replacement

Prosthetic radial head stem pull-out as a mode of failure: a biomechanical study

Anatomical Monopolar Press-Fit Radial Head Arthroplasty: Surgical Technique and Expected Outcomes

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