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CC BY-NC-ND 4.0 · J Wrist Surg 2022; 11(05): 425-432
DOI: 10.1055/s-0041-1742098
Scientific Article

Bone Remodeling after Ulna Head Replacement in Distal Radioulnar Joint Arthroplasty: A Radiographic Comparison between a Partial and a Total Ulna Head Concept

Elisabeth Brogren 
1   Department of Hand Surgery, Skåne University Hospital, Malmö, Sweden
2   Department of Translational Medicine, Lund University, Lund, Sweden
,
Antonio Abramo
1   Department of Hand Surgery, Skåne University Hospital, Malmö, Sweden
2   Department of Translational Medicine, Lund University, Lund, Sweden
,
Magnus Tägil 
3   Department of Orthopedics, Skåne University Hospital, Malmö, Sweden
4   Department of Clinical Sciences, Lund University, Lund, Sweden
› Institutsangaben
Funding This research was supported by R&D grant from Region Skåne, Sweden.
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Abstract

Background Ulna head arthroplasty has become an eligible solution for injury or disease in the distal radioulnar joint. Bone resorption beneath the prosthetic head is often reported, but mechanism poorly understood.

Purpose The aims were to evaluate bone remodeling and radiological instability in two conceptually different distal radioulnar joint arthroplasties: the total and the partial ulna head replacement.

Patients and Methods We conducted a retrospective radiographic assessment of 51 ulna head arthroplasties; 26 Herbert ulna (total ulna head replacement) and 25 First Choice (partial ulna head replacement), to analyze periprosthetic bone resorption and radiologic instability. Intraoperative/immediate postoperative and 1-year radiographs were reviewed by two independent assessors. The radiographic follow-up averaged 13 (10–17) months. The size of the stem in relation to the diameter of the ulna (filling ratio) was measured on the intraoperative/immediate postoperative radiographs. Bone resorption beneath the collar of the prothesis was measured on the 1-year radiographs and expressed as a bone resorption index (BRI) between the length of the resorption and the length of the implant stem. Radiological stability was measured on both the preoperative and the 1-year lateral radiographs.

Results The total ulna head prothesis presented with more extensive bone resorption beneath the prosthetic head than the partial ulna head prothesis at 1-year post surgery (p <0.001). The filling ratio did not influence the 1-year bone resorption and there was no difference regarding radiological instability between the two prosthetic designs.

Conclusion The pattern of bone adaptions after an ulna head prothesis may differ due to design and concept of the prosthesis.

Keywords

ulna head arthroplasty - distal radioulnar joint - bone resorption - stress shielding

Ethical Review Committee Statement

The study was approved by Lund University Ethical Review Board, Sweden No. 2015/110 and No. 2015/121.


Location

The work was performed at the Department of Translational Medicine and the Department of Clinical Sciences, both at Lund University, Lund, Sweden




Publikationsverlauf

Eingereicht: 05. Oktober 2021

Angenommen: 17. November 2021

Artikel online veröffentlicht:
20. Januar 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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