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Title: Effect of hoop stress fracture on micromotion of textured ingrowth stems for radial head replacement
Authors: Chanlalit C.
Shukla D.R.
Fitzsimmons J.S.
An K.-N.
O'Driscoll S.W.
Keywords: arm prosthesis
clinical article
human tissue
priority journal
radius fracture
stress fracture
Aged, 80 and over
Analysis of Variance
Arthroplasty, Replacement, Elbow
Coated Materials, Biocompatible
Elbow Joint
Elbow Prosthesis
Fractures, Stress
Prosthesis Design
Prosthesis Failure
Random Allocation
Stress, Mechanical
Surface Properties
Issue Date: 2012
Abstract: Background: Successful bone ingrowth around cementless implants requires adequate initial stability. Hoop stress fractures during stem insertion can potentially hinder prosthesis stability. Hypothesis: We hypothesized that an oversized radial head prosthetic stem (1 mm "too large" and causing a hoop stress fracture during insertion) would result in an unacceptable amount of micromotion. Materials and methods: Grit-blasted radial head prosthetic stems were implanted into cadaveric radii. Rasp and stem insertion energies were measured, along with micromotion at the stem tip. The sizes were increased until a fracture developed in the radial neck. Results: Prosthetic radial head stems that were oversized by 1 mm caused small cracks in the radial neck. Micromotion of oversized stems (42 ± 7 μm) was within the threshold conducive for bone ingrowth (<100 μm) and not significantly different from that for the maximum sized stems (50 ± 12 μm) (P ≥.4). Discussion: Contrary to our hypothesis, hoop stress fractures caused by implantation of a stem oversized by 1 mm did not result in loss of stability. Stem micromotion remained within the range for bone ingrowth and was not significantly diminished after the fracture. This suggests that if a crack occurs during the final stages of stem insertion, it may be acceptable to leave the stem in place without adding a cerclage wire. Conclusion: A small radial neck fracture occurring during insertion of a radial head prosthetic stem oversized by 1 mm does not necessarily compromise initial stability. © 2012 Journal of Shoulder and Elbow Surgery Board of Trustees.
ISSN: 10582746
Appears in Collections:SCOPUS 1983-2021

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