{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T06:03:25Z","timestamp":1790402605481,"version":"4.1.0"},"reference-count":5,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"Supplement_1_Part_2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2010,9]]},"abstract":"\n BACKGROUND:<\/jats:title>\n Insertion of a radial head implant that results in radial overlengthening has been associated with altered elbow kinematics, increased radiocapitellar joint forces, capitellar erosions, early-onset arthritis, and loss of elbow flexion. The purpose of this study was to identify clinical and radiographic features that may be used to diagnose overlengthening of the radius intraoperatively and on postoperative radiographs.<\/jats:p>\n <\/jats:sec>\n \n METHODS:<\/jats:title>\n Radial head implants of varying thicknesses were inserted into seven cadaver specimens, which were then assessed clinically and radiographically. Eight stages were examined: the intact specimen (stage 1); repair of the lateral collateral ligament (stage 2); radial head resection with repair of the lateral collateral ligament (stage 3); insertion of an implant of the correct thickness (stage 4); and insertion of an implant that resulted in radial overlengthening of 2 mm (stage 5), 4 mm (stage 6), 6 mm (stage 7), or 8 mm (stage 8). The specimens were tested with and without muscle loading to simulate resting muscle tone and surgical paralysis, respectively. At each stage, radiographs were made to measure the ulnohumeral joint space and the lateral ulnohumeral joint was visually assessed.<\/jats:p>\n <\/jats:sec>\n \n RESULTS:<\/jats:title>\n We identified no difference, with regard to medial ulnohumeral joint incongruity as seen radiographically, among stages 1 through 6 during the tests with muscle loading. A significant difference in medial ulnohumeral joint incongruity was found in stages 7 (p = 0.003) and 8 (p < 0.001). The clinical (visually assessed) lateral ulnohumeral joint space gap was negligible in stages 1 through 4 but increased significantly at all stages involving overlengthening (gross gap, 0.9 mm with 2 mm of erlengthening [p = 0.005], 2.3 mm with 4 mm of overlengthening [p < 0.001], 3.4 mm with 6 mm [p < 0.001], and 4.7 mm with 8 mm [p < 0.001]).<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS:<\/jats:title>\n Incongruity of the medial ulnohumeral joint becomes apparent radiographically only after overlengthening of the radius by \u22656 mm. Intraoperative visualization of a gap in the lateral ulnohumeral joint is a reliable indicator of overlengthening following the insertion of a radial head prosthesis.<\/jats:p>\n <\/jats:sec>\n \n CLINICAL RELEVANCE:<\/jats:title>\n This in vitro study indicates that the clinical (visual) observation of a lateral ulnohumeral joint gap is a reliable indicator of overlengthening following implantation of a radial head prosthesis. In contrast, radiographic measurements are relatively insensitive and cannot reliably demonstrate overlengthening of <6 mm.<\/jats:p>\n <\/jats:sec>\n \n ORIGINAL ABSTRACT CITATION:<\/jats:title>\n \u201cDetermination of Correct Implant Size in Radial Head Arthroplasty to Avoid Overlengthening\u201d (2009;91:1738-46).<\/jats:p>\n <\/jats:sec>","DOI":"10.2106\/jbjs.j.00356","type":"journal-article","created":{"date-parts":[[2010,9,15]],"date-time":"2010-09-15T15:29:40Z","timestamp":1284564580000},"page":"250-257","source":"Crossref","is-referenced-by-count":38,"title":["Determination of Correct Implant Size in Radial Head Arthroplasty to Avoid Overlengthening"],"prefix":"10.2106","volume":"92","author":[{"given":"George S.","family":"Athwal","sequence":"first","affiliation":[{"name":"Hand and Upper Limb Centre, St. Joseph's Health Care, 268 Grosvenor Street, London, ON N6A 4L6, Canada. E-mail address for G.S. Athwal:"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon G.","family":"Frank","sequence":"additional","affiliation":[{"name":"Hand and Upper Limb Centre, St. Joseph's Health Care, 268 Grosvenor Street, London, ON N6A 4L6, Canada. E-mail address for G.S. Athwal:"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruby","family":"Grewal","sequence":"additional","affiliation":[{"name":"Hand and Upper Limb Centre, St. Joseph's Health Care, 268 Grosvenor Street, London, ON N6A 4L6, Canada. E-mail address for G.S. Athwal:"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth J.","family":"Faber","sequence":"additional","affiliation":[{"name":"Hand and Upper Limb Centre, St. Joseph's Health Care, 268 Grosvenor Street, London, ON N6A 4L6, Canada. E-mail address for G.S. Athwal:"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Johnson","sequence":"additional","affiliation":[{"name":"Hand and Upper Limb Centre, St. Joseph's Health Care, 268 Grosvenor Street, London, ON N6A 4L6, Canada. E-mail address for G.S. Athwal:"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Graham J.W.","family":"King","sequence":"additional","affiliation":[{"name":"Hand and Upper Limb Centre, St. Joseph's Health Care, 268 Grosvenor Street, London, ON N6A 4L6, Canada. E-mail address for G.S. Athwal:"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"issue":"Suppl. 2(Pt 1)","key":"bib1-20230714","first-page":"63","article-title":"Radial head arthroplasty with a modular metal spacer to treat acute traumatic elbow instability","volume":"90","year":"2008","journal-title":"Surgical technique. J Bone Joint Surg Am"},{"key":"bib2-20230714","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1016\/j.jhsa.2005.06.012","article-title":"Reference points for radial head prosthesis size","volume":"31","year":"2006","journal-title":"J Hand Surg Am."},{"key":"bib3-20230714","first-page":"413","article-title":"Validation of the lesser sigmoid notch of the ulna as a reference point for accurate placement of a prosthesis for the head of the radius: a cadaver study","volume":"89","year":"2007","journal-title":"J Bone Joint Surg Br."},{"key":"bib4-20230714","doi-asserted-by":"crossref","first-page":"1738","DOI":"10.2106\/JBJS.H.01161","article-title":"Determination of correct implant size in radial head arthroplasty to avoid overlengthening","volume":"91","year":"2009","journal-title":"J Bone Joint Surg Am."},{"key":"bib5-20230714","doi-asserted-by":"crossref","first-page":"637","DOI":"10.1016\/j.jhsa.2007.02.024","article-title":"Lateral ulnohumeral joint space widening is not diagnostic of radial head arthroplasty overstuffing","volume":"32","year":"2007","journal-title":"J Hand Surg Am."}],"container-title":["Journal of Bone and Joint Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/00004623-201009001-00012","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T13:35:28Z","timestamp":1787751328000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/00004623-201009001-00012"}},"subtitle":["Surgical Technique"],"short-title":[],"issued":{"date-parts":[[2010,9]]},"references-count":5,"journal-issue":{"issue":"Supplement_1_Part_2","published-print":{"date-parts":[[2010]]}},"URL":"https:\/\/doi.org\/10.2106\/jbjs.j.00356","relation":{},"ISSN":["0021-9355","1535-1386"],"issn-type":[{"value":"0021-9355","type":"print"},{"value":"1535-1386","type":"electronic"}],"subject":[],"published":{"date-parts":[[2010,9]]}}}