The stabilizing influence of radial head arthroplasty was studied in eight
medial collateral ligament deficient anatomic specimen elbows. An elbow tes
ting apparatus, which used computer controlled pneumatic actuators to apply
tendon loading, was used to simulate active elbow flexion. The motion path
ways of the elbow were measured using an electromagnetic tracking device, w
ith the forearm in supination and pronation, As a measure of stability, the
maximum varus to valgus laxity over the range of elbow flexion was determi
ned From the difference between varus and valgus gravity loaded motion path
ways. After transection of the medial collateral ligament, the radial head
was excised and replaced with either a silicone or one of three metallic ra
dial head prostheses. Medial collateral ligament transection caused a signi
ficant increase in the maximum varus to valgus laxity to 18.0 degrees +/- 3
,2 degrees, After radial head excision, this laxity increased to 35.6 degre
es +/- 10,3 degrees, The silicone implant conferred no increase in elbow st
ability, with a maximum varus to valgus laxity of 32.5 degrees +/- 15.5 deg
rees, All three metallic implants improved the valgus stability of the medi
al collateral ligament deficient elbow, providing stability similar to the
intact radial head. The use of silicone arthroplasty to replace the radial
head in the medial collateral ligament deficient elbow must be questioned.
Metallic radial head arthroplasty provides improved valgus stability, appro
aching that of an intact radial head.