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Partial elbow replacement (Radiocapitellar Uni-elbow arthroplasty)

April 24th, 2007

The role for "Uni-elbow" arthroplasty (partial elbow replacement) is evolving. The procedure involves a metallic resurfacing of the capitellum in association, in most cases, with radial head replacement.

The most common indication is as a Revision Procedure to treat lateral elbow pain and stiffness because of cartilage wear on the capitellum, following previous radial head replacement for fracture.When longitudinal radioulnar instability, collateral ligament injury, or overstuffing of the radiocapitellar joint following radial head replacement exist, shear and compressive loads on the capitellum are increased, and may lead to capitellar arthrosis.

Although long-term outcomes following Uni-elbow arthroplasty are unknown at this time, my early assessment and personal communication with colleagues at the Mayo Clinic, where the implant was designed, lead me to beleive that it will be a valuable option for patients with recalcitrant radiocapitellar pain due to lateral elbow arthrosis.

Related Photos:

Uni-elbow arthroplasty includes radial head replacement and capitellar resurfacing

Preoperative AP xray after radial head replacement for fracture shows capitellar lucency. This patient complains of lateral pain, stiffness, and popping

Preoperative lateral xray shows that the radial head implant is posterior to the capitellum, suggestive of LCL incompetence. In fact, exam showed a positive Pivot Shift consistent with Posterolateral Rotary Instability

Capitellar resurfacing was performed along with LCL reconstruction using Tibialis anterior allograft and biotenodesis screws. The radial head that had been placed was securely fixed, and could not be removed.

Postoperative AP xray after capitellar resurfacing

Postoperative lateral xray. This patient has enjoyed complete pain relief and improved motion and stability at 6 months

Related Videos:

Intraoperative video following Capitellar resurfacing and LCL reconstruction