title: Can ulnar variance be used to detect overstuffing after radial head arthroplasty?
abstract: BACKGROUND
  Overstuffing of the radiocapitellar joint during metallic radial head arthroplasty has been reported to cause loss of elbow flexion, capitellar erosion, and early-onset osteoarthritis. Although this is known, there is no agreed-on measurement approach to determine whether overstuffing has occurred.
  
  
  OBJECTIVE
  We therefore hypothesized that overlengthening the radial head during radial head arthroplasty changes the ulnar variance in the wrist.
  
  
  METHODS
  Seven cadaveric radii were implanted with radial head prostheses of increasing thickness. Each specimen was implanted successively with increasingly thick radial head prostheses measuring 2, 4, and 6 mm thicker than the native radial head, and radiographs were taken after implantation of each prosthesis. The ulnar variance with each prosthesis was measured using the method of perpendiculars.
  
  
  RESULTS
  The ulnar variance of the native and 2-mm (p = 0.04), 4-mm (p = 0.008), and 6-mm (p = 0.008) overly thick radial head prosthesis-implanted states decreased significantly with each incremental increase in prosthetic head thickness.
  
  
  CONCLUSIONS
  Implantation of thicker radial head prostheses decreased the ulnar variance. Our results indicate ulnar variance could be used to detect overstuffing of radial head prostheses.
  
  
  CONCLUSIONS
  The simplicity and reliability of ulnar variance make it a potentially useful indicator of overlengthening after radial head arthroplasty.
authors.affiliation: Department of Orthopedic Surgery, Korea University Guro Hospital, 97 Gurodong-gil, Guro-gu, Seoul, 152-703, Korea, moon@korea.ac.kr.
authors.forename: Jun-Gyu
authors.initials: JG
authors.lastname: Moon
authors.forename: Jin-Ho
authors.initials: JH
authors.lastname: Hong
authors.forename: Nitin
authors.initials: N
authors.lastname: Bither
authors.forename: Won-Yong
authors.initials: WY
authors.lastname: Shon
mesh_terms: D057929:Arthroplasty, Replacement, Elbow / Q000009:adverse effects* / Q000295:instrumentation; D001696:Biomechanical Phenomena; D002102:Cadaver; D004551:Elbow Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D058569:Elbow Prosthesis; D006801:Humans; D011474:Prosthesis Design; D011859:Radiography; D011884:Radius / Q000000981:diagnostic imaging / Q000601:surgery*; D016059:Range of Motion, Articular; D014457:Ulna / Q000000981:diagnostic imaging*
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