Stress shielding following radial head arthroplasty: the impact of preoperative bone quality

• Published in: Journal of shoulder and elbow surgery 2024-08, Vol.33 (8), p.1665-1671
• Main Authors: Ciais, Grégoire, Massin, Valentin, Tibbo, Meagan, Dardenne, Theopol, Abdellaoui, Mohamed, Ricón, Javier, Antoni, Maxime, Laumonerie, Pierre
• Format: Article
• Language: English
• Subjects: Arthroplasty; mopyc; morphology; prothesis; radial head; stress shielding
• ISSN: 1058-2746; 1532-6500; 1532-6500
• DOI: 10.1016/j.jse.2024.03.025

We sought to assess if the medullary diameter to cortical width ratio (MD:CW), canal flair index (CFI), and canal fill (CF) of the proximal radius were associated with the presence of stress shielding (SS) after a MoPyC radial head arthroplasty. We conducted a retrospective, international, multicenter (4 centers) study. A total of 100 radial head arthroplasties in 64 women and 36 men with a mean age of 58.40 years ± 14.90 (range, 25.00-91.00) were included. Radiographic measurements, including MD:CW, CFI, CF, and postoperative SS were captured at a mean follow-up of 3.9 years ± 2.8 (range, 0.5-11). SS was identified in 60 patients. Mean preoperative MD:CW, CFI, and CF were 0.55 ± 0.09, 1.05 ± 0.18, and 0.79 ± 0.11, respectively. The presence of SS was significantly associated with MD:CW (adjusted odds ratio = 13.66; P = .001), and expansion of the stem (adjusted odds ratio = 3.78; P = .001). The amount of the SS was significantly correlated with expansion of the stem (aβ 4.58; P