Arthroplasty of radial head using cementless modular bipolar endoprosthesis with metal-on-metal bearings

I.V. Boiko, V.B. Makarov, D.E. Shcherbakov, I.І. Zherdev, А.N. Domanskii, G.O. Lazarenko


Background. The authors of the article show the features of the surgical technique of implantation of the developed modular cementless bipolar endoprosthesis of radial head with metal-on-metal bearings, which was applied in the period from 2014 to 2017. Materials and me-thods. The developed cementless modular bipolar endoprosthesis of radial head with metal-on-metal bearings (material — medical stainless steel) was used in 14 patients, the mean age of them was 56 years (from 43 to 72 years). The average observation period was 18 months (from 6 to 24 months). Indications for radial head arthroplasty in all patients were multifragmental fractures and dislocation fractures type III–IV by Mason-Hotchkiss. The treatment outcome was evaluated by the Mayo Elbow Performance Score. Results. In case of Mason-Hotchkiss fractures type III, three basic methods of surgical treatment are used — resection of radial head, open reposition and internal osteosynthesis, radial head replacement. The resection of radial bone in case of stable elbow joint, as a rule, can always produce positive results in most patients without any additional violations in the function of the elbow joint. If other structures stabilizing elbow joint are damaged, the isolated resection of radial head always leads to complications such as progressive valgus instability of the elbow joint, radial bone shortening with an increase in the severity of the pain syndrome, both in the area of the hand and elbow joint; the risk of repeated forearm subluxation posteriorly is not excluded as well. The use of the developed modular endoprosthesis of radial head has allowed achieving the recovery of the elbow joint stability, the restoration of the rotational movements of the forearm with the preservation of the functional capacity of flexion-extention movement, as well as the restoration of radial bone length in all patients. According to the assessment system, the Mayo Elbow Performance Score was 88.5 points. Conclusions. Developed modular bipolar endoprosthesis of radial head made it possible to obtain positive results in all patients within 2 years after the surgery. A differentiated approach to the choice of surgical access with various da-mages to radial head, early mobilization of movements in the elbow joint and the restoration of the capsular-ligament apparatus of the elbow joint are determining factors for the achievement of positive clinical and functional results of radial head arthroplasty using developed modular bipolar endoprosthesis of radial head.


surgical technique of radial head arthroplasty; bipolar cementless endoprosthesis of radial head; radial head fracture


Johnson J.A., Beingessner D.M., Gordon K.D., Dunning C.E., Stacpoole R.A., King G.J. Kinematics and stability of the fractured and implant-reconstructed radial head // J. Shoulder Elbow. Surg. — 2005. — № 14. — Р. 195-201.

King G.J., Zarzour Z.D., Rath D.A., Dunning C.E., Patterson S.D., Johnson J.A. Metallic radial head arthroplasty improves valgus stability of the elbow // Clin. Orthop. — 1999. — № 368. — Р. 114-25.

Morrey B.F., Tanaka S., An K.N. Valgus stability of the elbow. A definition of primary and secondary constraints // Clin. Orthop. — 1991. — № 265. — Р. 187-95.

McKee M.D., Pugh D.M., Wild L.M., Schemitsch E.H., King G.J. Standard surgical protocol to treat elbow dislocations with radial head and coronoid fractures. Surgical technique // J. Bone Joint Surg. Am. — 2005. — № 87. — Р. 22-32.

Beingessner D.M., Dunning C.E., Gordon K.D., Johnson J.A., King G.J. The effect of radial head excision and arthroplasty on elbow kinematics and stability // J. Bone Joint Surg. Am. — 2004. — № 86. — Р. 1730-9.

Ring D., King G. Radial head arthroplasty with a modular metal spacer to treat acute traumatic elbow instability. Surgical technique // J. Bone Joint Surg. Am. — 2008. — № 90. — Р. 63-73.

Flinkkilä T., Kaisto T., Sirinö K., Hyvönen P., Leppilahti J. Short- to mid-term results of metallic press-fit radial head arthroplasty in unstable injuries of the elbow // J. Bone Joint Surg. Br. — 2012. — № 94-B(6). — Р. 805-810. — doi: 10.1302/0301-620X.94B6.28176.

Burkhart K.J., Mattyasvszky S.G., Runkel M., Schwarz C., Rump A., Kuechle R., Hessmann M.H., Rommens P.M., Müller L.P. Clinical and radiological results after Judet’s bipolar radial head prosthesis: long term effects // Ob Ex. — 2011. — № 6(2). — Р. 108-114.

Burkhart K.J., Mattyasovszky S.G., Runkel M., Schwarz C., Küchle R., Hessmann M.H., Rommens P.M., Lars M.P. Mid- to long-term results after bipolar radial head arthroplasty // J. Shoulder Elbow. Surg. — 2010. — № 19. — Р. 965-972. — doi: 10.1016/j.jse.2010.05.022.

Harrington I.J., Sekyi-Otu A., Barrington T.W., Evans D.C., Tuli V. The functional outcome with metallic radial head implants in the treatment of unstable elbow fractures: a long-term review // J. Trauma. — 2001. — № 50(1). — Р. 46-52. — doi: 10.1097/00005373-200101000-

Sarris I.K., Kyrkos M.J., Galanis N.N., Papavasi-liou K.A., Sayegh F.E., Kapetanos G.A. Radial head replacement with the MoPyC pyrocarbon prosthesis // J. Shoulder Elbow. Surg. — 2012. — № 21(9). — Р. 1222-1228. — doi: 10.1016/j.jse.2011.12.004.

Moon J.G., Berglund L.J., Zachary D., An K.N., O’Driscoll S.W. Radiocapitellar joint stability with bipolar versus monopolar radial head prostheses // J. Shoulder Elbow. Surg. — 2009. — № 18. — Р. 779-784. — doi: 10.1016/j.jse.2009.02.011.

Chen H., Wang Z., Shang Y. Clinical and Radiographic Outcomes of Unipolar and Bipolar Radial Head Prosthesis in Patients with Radial Head Fracture: A Systemic Review and Meta-Analysis // J. Invest. Surg. — 2017 Sep 13. — Р. 1-7. — doi: 10.1080/08941939.2017.1299262. [Epub ahead of print].

Пат. 83334 Україна, МКИ6 А 61F 2/38 Ендопротез голівки променевої кістки / І.В. Бойко, В.Б. Макаров, Д.Є. Щербаков, О.В. Сабсай. — № 201214490; Заявл. 18.12.12; Публік. 10.09.13, Бюл. № 17.

Cusick M.C., Bonnaig N.S., Azar F.M., Mauck B.M., Smith R.A., Throckmorton T.W. Accuracy and reliability of the Mayo Elbow Performance Score // J. Hand Surg. Am. — 2014 Jun. — № 39(6) — Р. 1146-50. — doi: 10.1016/j.jhsa.2014.01.041. Epub 2014 Mar 20.

Van Riet R.P., Sanchez-Soleto J., Morrey B.F. Fai-lure of metal radial head replacement // J. Bone Joint Surg. Br. — 2010. — № 92-B. — Р. 661-667. — doi: 10.1302/0301-620X.92B5.23067.

Laumonerie P., Reina N., Ancelin D., Delclaux S., Tibbo M.E., Bonnevialle N., Mansat P. Mid-term outcomes of 77 modular radial head prostheses // Bone Joint J. — 2017 Sep. — № 99-B(9). — Р. 1197-1203. — doi: 10.1302/0301-620X.99B9.BJJ-2016-1043.R2.

Johnson J.A., Beingessner D.M., Gordon K.D. et al. Kinematics and stability of the fractured and implant reconstructed radial head // J. Shoulder Elbow. Surg. — 2005. — № 14. — Р. 195S-201S.

King G.J., Zarzour Z.D., Rath D.A. et al. Metallic radial head arthroplasty improves valgus stability of the elbow // Clin. Orthop. — 1999. — № 368. — Р. 114-125.

Orbay J.L., Mijares M.R., Berriz C.G. The transverse force experienced by the radial head during axial loading of the forearm: A cadaveric study // Clin. Biomech. (Bristol, Avon). — 2016 Jan. — № 31. — Р. 117-22. — doi: 10.1016/j.clinbiomech.2015.10.007. Epub 2015 Oct 17.

Van Riet R.P., van Glabbeek F., Baumfeld J.A. et al. The effect of the orientation of the non-circular radial head on elbow kinematics // Clin. Biomech. — 2004. — № 19. — Р. 595-599.

Boyko I.V., Makarov V.B., Sherbakov D.Ye., Radzhabov O.S. Biomechanical study of load distribution features in the head and neck of radius // Trauma. — 2013. — Vol. 14, № 1. — P. 22-27.

Strafun S.S., Boyko I.V., Makarov V.B., Sherba-

kov D.Ye, Radzhabov O.S., Strafun A.S. Comparative analysis of the stresses in the “bone-implant” system during radial head arthroplasty with different implants // Trauma. — 2015. — Vol. 16, № 3. — P. 5-13.

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