Linking of total elbow prosthesis during surgery; a biomechanical analysis

Background: Presently, 2 types of elbow prostheses are used: unlinked and linked. The Latitude total elbow prosthesis allows the surgeon to decide during the implantation whether the prosthesis is placed unlinked or linked, and whether the native radial head is retained, resected, or replaced. The purpose of this study is to assess and to compare the varus and valgus laxity of the unlinked and linked version of the latitude total elbow prosthesis with: (1) the native radial head preserved, (2) the native radial head excised, and (3) the native radial head replaced by a radial head component. Methods: Biomechanical testing was performed on 14 fresh-frozen upper limb specimens. Results: Linking the prosthesis predominantly influences the valgus laxity of the elbow. Discussion/conclusion: Linking the Latitude total elbow prosthesis results in increased valgus stability. In the linked version of the total elbow prosthesis, the radial head only plays a small part in both valgus and varus stability. An unlinked situation is not advised in absence of a native radial head or in case of inability to replace the radial head. Level of evidence: Basic Science Study, Biomechanics. (C) 2013 Journal of Shoulder and Elbow Surgery Board of Trustees.