Greater radial tuberosity size is associated with distal biceps tendon rupture: a quantitative 3-D CT case-control study.

Purpose: During pronation, the distal biceps tendon and radial tuberosity internally rotate into the radioulnar space, reducing the linear distance between the radius and ulna by approximately 50%. This leaves a small space for the distal biceps tendon to move in and could possibly cause mechanical impingement or rubbing of the distal biceps tendon. Hypertrophy of the radial tuberosity potentially increases the risk of mechanical impingement of the distal biceps tendon.

Operative vs. nonoperative treatment for Mason type 2 radial head fractures: a randomized controlled trial.

Background: The optimal treatment of isolated displaced partial articular radial head fractures remains controversial. The aim of this randomized controlled trial was to compare the functional outcome of operative treatment with nonoperative treatment in adults with an isolated Mason type 2 radial head fractures.

Methods: In this multicenter randomized controlled trial, patients from 18 years of age with an isolated partial articular fracture of the radial head were randomly assigned to operative treatment by means of open reduction and screw fixation or nonoperative treatment with a pressure bandage.

Management of the failed radial head arthroplasty.

Primary radial head arthroplasty (RHA) produces good or excellent results in approximately 85% of patients. However, complications are not uncommon and have been described in up to 23% of cases.The number of RHA is increasing, and consequently the absolute number of complications is expected to rise as well.

Global trends in indications for total elbow arthroplasty: a systematic review of national registries.

National registries provide useful information in understanding outcomes of surgeries that have late sequelae, especially for rare operations such as total elbow arthroplasty (TEA).A systematic search was performed and data were compiled from the registries to compare total elbow arthroplasty outcomes and evaluate trends. We included six registries from Australia, the Netherlands, New Zealand, Norway, the United Kingdom and Sweden.

Why does radial head arthroplasty fail today? A systematic review of recent literature.

Since the introduction of the radial head prosthesis (RHP) in 1941, many designs have been introduced. It is not clear whether prosthesis design parameters are related to early failure. The aim of this systematic review is to report on failure modes and to explore the association between implant design and early failure.

Outcomes after revision total elbow arthroplasty: a systematic review.

Background: Although revision arthroplasty surgery is a frequently used treatment for failed total elbow arthroplasty (TEA), published results are conflicting. The aim of this systematic review was to provide an overview of the outcomes of revision TEA surgery.

Methods: A systematic literature search was performed in major databases to find articles relating to outcomes after revision of TEA.

Interobserver reliability of radiographic assessment after radial head arthroplasty.

Background: Radiographs are part of routine clinical care after radial head arthroplasty (RHA). Therefore, the aim of this diagnostic study was to assess the interobserver reliability of radiographic assessment following RHA.

Methods: Anteroposterior (AP) and lateral radiographs of 24 consecutive patients who underwent press-fit bipolar RHA were evaluated with respect to 14 parameters by 14 orthopaedic surgeons specializing in the elbow: shaft loosening (AP, lateral), subcollar bone resorption, nonbridging heterotopic ossification, capitellar erosion, capitellar osteopenia, implant size, ulnohumeral joint gapping, ulnohumeral joint degeneration, proximal radio-ulnar joint congruency, stem size, stem positioning (AP, lateral) and component dissociation or polyethylene wear of the head with increased angulation.

Continuous passive motion and physical therapy (CPM) versus physical therapy (PT) versus delayed physical therapy (DPT) after surgical release for elbow contractures; a study protocol for a prospective randomized controlled trial.

Background: The elbow is prone to stiffness after trauma. To regain functional elbow motion several conservative- and surgical treatment options are available. Conservative treatment includes physical therapy, intra-articular injections with corticosteroids and a static progressive or dynamic splinting program.

Clinical and radiographic outcome of revision surgery of total elbow prosthesis: midterm results in 19 cases.

Background: The aim of this study is to report on the midterm outcomes and complications of revision surgery of total elbow arthroplasty.

Methods: All patients who had undergone total elbow arthroplasty revision surgery between 2009 and 2014 with semiconstrained total elbow prostheses were prospectively enrolled in the study. Records were reviewed for demographic data; baseline measurements; and several follow-up assessments including the Mayo Elbow Performance Score (MEPS), visual analog scale (VAS) score for pain, Oxford Elbow Score, range of motion, satisfaction, and radiographs.

Clinical and radiographic outcome of revision surgery of radial head prostheses: midterm results in 16 patients.

Background: Little is known about revision surgery of radial head arthroplasty. The aim of this study was to report on the clinical and radiographic outcome of revision arthroplasty of the elbow with a bipolar metallic radial head prosthesis.

Methods: Between 2006 and 2013, we used either a press-fit or cemented RHS bipolar radial head prosthesis for revision surgery of radial head arthroplasty in 16 patients.

Radial Head Arthroplasty: A Systematic Review.

Background: Despite the expanding body of literature on radial head arthroplasty, the increasing understanding of elbow anatomy, biomechanics, and kinetics, and the evolution of surgical techniques and prosthesis designs, there is currently no evidence to support one type of radial head prosthesis over another. The purposes of the present report were to review the literature and to explore the association between prosthesis design variables and the timing of surgery and the outcome of modern radial head arthroplasty.

Methods: The literature search was limited to studies involving skeletally mature patients.

Cemented bipolar radial head arthroplasty: midterm follow-up results.

Background: Theoretical advantages of bipolar over monopolar radial head arthroplasty include better accommodation of radiocapitellar malalignment, reduction of capitellar abrasion, and reduction of stress at the bone-to-cement and cement-to-implant interfaces. Our purpose was to report the midterm results of cemented bipolar radial head arthroplasty.

Methods: Twenty-five patients were treated by cemented bipolar radial head arthroplasty for acute fracture of the radial head, earlier treatment that had failed, or posttraumatic sequelae.

Press-fit bipolar radial head arthroplasty, midterm results.

Background: Theoretical advantages of bipolar compared with monopolar radial head arthroplasty include better accommodation of radiocapitellar malalignment, reduction of capitellar abrasion, and reduction of stress at the bone-implant interfaces. Our purpose was to report the midterm results of press-fit bipolar radial head arthroplasty.

Methods: Thirty patients were treated by press-fit bipolar radial head arthroplasty for acute fracture of the radial head, failed earlier treatment, or post-traumatic sequelae.

The Size of the Radial Tuberosity is Not Related to the Occurrence of Distal Biceps Tendon Ruptures: A Case-Control Study.

Introduction: Hypertrophic changes at the radial tuberosity have traditionally been related to distal biceps tendon degeneration and rupture. From supination to pronation of the forearm, the space available for the distal biceps tendon between de lateral ulna and radial bicipital tuberosity (RBT) decreases by almost 50%. A hypertrophic change at the radial tuberosity further reduces this space with impingement of the distal biceps tendon as a result.

Current concepts in the management of radial head fractures.

Fracture of the radial head is a common injury. Over the last decades, the radial head is increasingly recognized as an important stabilizer of the elbow. In order to maintain stability of the injured elbow, goals of treatment of radial head fractures have become more and more towards restoring function and stability of the elbow.

Refixation techniques and approaches for distal biceps tendon ruptures: a systematic review of clinical studies.

Background: Surgical fixation is the preferred method of treatment for the ruptured distal biceps tendon in active patients. To date, no fixation technique has been proven superior in a clinical setting. The purpose of the study was to systematically review the available literature on approach and fixation methods for distal biceps tendon repair in a clinical setting and to determine the optimal fixation methods of the distal biceps tendon on the radial tuberosity.

The effect of trauma and patient related factors on radial head fractures and associated injuries in 440 patients.

Background: Radial head fractures are commonly interpreted as isolated injuries, and it is assumed that the energy transferred during trauma has its influence on the risk on associated ipsilateral upper limb injuries. However, relationships between Mason classification, mechanism of injury, and associated injuries have been reported only once before in a relatively small population. The purpose of this study was to define whether trauma mechanism and patient related factors are of influence on the type of radial head fracture and associated injuries to the ipsilateral upper limb in 440 patients.

Reconstruction of distal biceps tendon ruptures with a cortical button.

Purpose: Reconstruction of the ruptured distal biceps tendon is best done with a cortical button technique according to recent biomechanical studies. However, clinical outcome studies that evaluate the cortical button reconstruction technique are scarce. The purpose of this study was to evaluate the results of a cortical button reconstruction technique in patients with a traumatic distal biceps tendon rupture.

Clinical relevance of distal biceps insertional and footprint anatomy.

Purpose: The aim of this review was to present an overview, based on a literature search, of surgical anatomy for distal biceps tendon repairs, based on the current literature.

Methods: A narrative review was performed using Pubmed/Medline using key words: Search terms were distal biceps, insertional, and anatomy.

Results: Last decade, the interest in both reconstruction techniques, as well as surgical anatomy of the distal biceps tendon, has increased.

Semiconstrained total elbow arthroplasty for posttraumatic arthritis or deformities of the elbow: a prospective study.

Purpose: To report the short-term results for posttraumatic total elbow arthroplasty.

Methods: We included patients presenting to our hospital with symptomatic chronic posttraumatic arthritis or deformities of the elbow, aged 55 to 90 years. All patients had reconstruction with a Coonrad-Morrey prosthesis.

Best approach for the repair of distal biceps tendon ruptures.

The preferred treatment of distal biceps tendon ruptures is by operative repair. However, the best approach for repair (single vs double incision) is still subject of debate. Grewal and colleagues recently presented the results of a randomized clinical trial evaluating two different surgical approaches for the repair of distal biceps tendon ruptures.

Surgical treatment of post-traumatic elbow stiffness: a systematic review.

Background: Trauma to the elbow is a common cause of joint stiffness that might require surgical release. Release of the stiff elbow can be done by open or arthroscopic approach. There is no high-level evidence for the best surgical treatment modality for post-traumatic elbow stiffness.

Long-term results after ulnar collateral ligament reconstruction of the elbow in European athletes with interference screw technique and triceps fascia autograft.

Background: In the last decade, there has been increasing interest in medial ulnar collateral ligament (MUCL) reconstruction techniques for MUCL insufficiency of the elbow. All case series are based on American and Asian Athletes and use primarily a palmaris longus tendon or gracilis tendon as an autograft in reconstructions. A new technique is the interference screw fixation.

Metabolic and genetic regulation of cardiac energy substrate preference.

Proper heart function relies on high efficiency of energy conversion. Mitochondrial oxygen-dependent processes transfer most of the chemical energy from metabolic substrates into ATP. Healthy myocardium uses mainly fatty acids as its major energy source, with little contribution of glucose.