Case report
Radiocapitellar hemiarthroplasty for radiocapitellar arthritis: A report of three cases

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Materials and methods

Three patients have been treated at our institution with custom metallic capitellar resurfacing arthroplasty as part of a radiocapitellar hemiarthroplasty for radiocapitellar arthritis. In all cases, the radiocapitellar arthritis had developed owing to chronic longitudinal radioulnar dissociation. After Institutional Review Board approval was obtained, medical records were reviewed, and each patient was seen in the office for a physical examination and radiographic follow-up. Elbow function was

Patient 1

A 50-year-old, right-handed computer worker sustained a work-related, right-sided comminuted radial head fracture when he fell from a ladder. Radial head excision was performed at that time. Four months later, he experienced ulnar-sided wrist pain due to ulnocarpal abutment, which did not resolve with arthroscopic débridement of the triangular fibrocartilage and shortening of the distal ulna.

At 31 months after the injury, he presented with ulnocarpal impingement, instability of the distal

Discussion

Three cases are reported in which capitellar resurfacing arthroplasty as part of a radiocapitellar hemiarthroplasty was performed for symptomatic radiocapitellar arthritis in the setting of chronic longitudinal radioulnar dissociation. In the first and second patients, there was erosion and softening of the osteopenic capitellum from the metallic radial head prosthesis that led to painful degenerative changes at the capitellum. The capitellum perhaps had been softened because of the long period

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    Anconeous interposition and radial head resection are well-known salvage options; however, they have limitations because of the loss of the lateral column of the elbow.1,13 Newer salvage procedures include radiocapitellar hemiarthroplasty using a custom metallic capitellar resurfacing implant, prosthetic arthroplasty with a metal capitellar resurfacing implant, and a polyethylene-articulating surface.13,14,18,28 Although preliminary studies show promising results, no studies followed patients for longer than 6 years, and approximately one-third of patients required a second surgery.4,28

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