Influence of prosthetic design on radiocapitellar concavity-compression stability

Background: Radial head prostheses are available with multiple geometric properties. The effect of design features on radiocapitellar stability has not been investigated. Hypothesis: The shape (depth and radius of curvature) of the articulating dish of a radial head prosthesis affects radiocapitellar stability. Materials and methods: Radiocapitellar stability due to concavity-compression was evaluated in 8 fresh frozen elbows before and after radial head replacement with 2 different designs of radial head implants (RH 1 and RH 2). Both functioned as monopolar implants. Peak forces resisting subluxation and force-displacement characteristics were compared between the 2 and to the native radial head. Results: Radial head design significantly affected radiocapitellar stability. RH 1, which had a deeper dish than RH 2, required significantly higher peak forces to subluxate the radiocapitellar joint. The peak subluxation forces and the slopes of the force-displacement curves were not significantly different from the native radial head for RH 1, but they were for RH 2. Conclusion: The shape of the articular dish (depth, radius of curvature) of a monopolar radial head implant affects its contribution to radiocapitellar stability. An implant that mimics normal anatomy is more effective than a shallow radial head implant with a radius of curvature that is longer than normal. Level of evidence: Basic Science, Biomechanical Cadaver Study. (C) 2011 Journal of Shoulder and Elbow Surgery Board of Trustees.