The Radial Head Replacement System was approved by the AO Technical Commission in December 2024 as a temporary spacer solution to treat acute radial head trauma including fracture dislocations. The implant (Fig 1) has design features to prevent longitudinal collapse of the radius, allowing associated soft tissue injuries to heal with the radial head in an anatomic position [1].

The Radial Head Replacement System offers 30 different one-piece smooth stem implants options and addresses over 90% of the anatomic range for radial head diameter. The implant array includes three implant head diameters, three head heights and four different stem diameters (Fig 2). The smooth stem design is associated with fewer cases of implant loosening and subsequent removal than press-fit implants [2].

The sterile, single-use instrumentation (Fig 3) aims to improve efficiency, reduce costs, and minimize delays in surgery [3-6], while the radiolucent color-coded trials (Fig 3) are designed for better visualization of the proximal ulna and joint, and allow for in-situ height determination [7]. Further advantages offered by the new system include reduced complexity, and ease of use for surgeons with varying levels of skill and experience.

Indications as approved by the AO Technical Commission

• Temporary spacer following acute trauma to the radial head

Contraindications as approved by the AO Technical Commission

Absolute contraindications include

• infection
• sepsis,
• osteomyelitis

Relative contraindications include

• uncooperative patient or patient with neurologic disorders who are incapable of following directions
• osteoporosis
• metabolic disorders which may impair bone formation
• osteomalacia
• distant foci of infections which may spread to the implant site
• rapid joint destruction
• marked bone loss
• bone resorption apparent on roentgenogram

References

1. Chien HY, Chen AC, Huang JW, et al. Short-to medium-term outcomes of radial head replacement arthroplasty in posttraumatic unstable elbows: 20 to 70 months follow-up. Chang Gung Medical Journal. 2010;33(6):668.
2. DePuy Synthes Report: Memo Guide Wire Material. 2019. Ref: 0000287828
3. R. D. Shippert, "A study of time-dependent operating room fees and how to save $100,000 by using time-saving products," American Journal of Cosmetic Surgery, vol 22, no. 1, pp. 25-34, 2005
4. Traverso LW, Hargrave K. A prospective cost analysis of laparoscopic cholecystectomy. Am J Surg. 1995; 169;503-506.
5. Anwar F, Shoaib RF. Critical incident identification in common orthopaedic injury. JPMA. The Journal of the Pakistan Medical Association. 2009;59(2):71-74
6. McCormack J. Satisfy surgeons by improving instrument turnaround time. Materials management in health care. 1995;4
7. DePuy Synthes Report: See Better Size Better Memo. 2019. Ref: 0000290188.