Traumatic acute stem rupture in stress shielding bone resorption of a bipolar radial head arthroplasty: case report and literature review

Main Article Content

Carlo Cardile
Paolo Arrigoni
Carlo Cazzaniga
Carlo Zaolino
Paolo Ragni
Pietro Simone Randelli


Radial head Arthroplasty, stress shielding, fractures, stem rupture, bone resorption


Bone resorption around the proximal portion of the stem of a radial head prosthesis is a frequent phenomenon. In the vast majority of cases it is not correlated with to be without clinical manifestations.  This radiographic sign, refers to the stress shielding effect has been more described in total hip replacement surgery. Few authors have noticed this phenomenon in radial head replacement. however, given the increasing number of these procedures, a careful surveillance is required in patients presenting this sign. We report a literature review and a case presentation of proximal stem rupture following a trauma in association to radiological periprosthetic bone resorption due to stress shielding and treated with revision surgery.


Download data is not yet available.
Abstract 1 | PDF Downloads 3


1 Heijink A, Kodde IF, Mulder PG, Veltman ES, Kaas L, van den Bekerom MP et al. (2016) Radial Head Artrhoplasty: a sistematic review. JBJS rev 2016;18;4(10). doi: 10.2106/JBJS.RVW.15.00095.
2 Pogliacomi F, Schiavi P, Pedrazzini A, Nosenzo A, Tocco S, Ceccarelli F. Modified Mason type III and IV radial head fractures: results of different surgical treatments. Acta Biomed. 2015;86(3):242–50
3 Delclaux S, Lebon J, Faraud A, Toulemonde J, Bonnevialle N, Coulet et al. . Complications of radial head prostheses. Int Orthop 2015;39(5):907-13. doi: 10.1007/s00264-015-2689-7
4 Kodde I, Heijink A, Kaas L, Mulder P, van Dijk N, Eygendaal D. Press-fit bipolar radial head arthroplasty, midterm results. J Shoulder Elbow Surg 2016;25:1235-1242. doi: 10.1016/j.jse.2016.02.007
5.Gruen TA, McNeice GM, Amstutz HC. Models of failure of cemented stemtype femoral components: a radiographic analysis of loosening. Clin Orthop Relat Res 1979;141:17-2.
6 Chanlalit C, Shukla DR, Fitzsimmons JS, An KN, O'Driscoll SW. Stress shielding around radial head prostheses. J Hand Surg AmOct 2012;37(10):2118-25. doi: 10.1016/j.jhsa.2012.06.020
7. Popovic N, Lemaire R, Georis P, Gillet P. Midterm results with a bipolar radial head prosthesis: radiographic evidence of loosening at the bone-cement interface. J Bone Joint Surg. 2007;89:2469-2476. doi: 10.2106/JBJS.F.00723
8. Huiskes R, Weinans H, Grootenboer H, Dxlstra M, Fudala B, Slooff T. Adaptive bone-remodeling theory applied to prosthetic design analysis. J Biomechanics 1987;20(11): 1135-1150. doi: 10.1016/0021-9290(87)90030-3.
9 Rotini R, Marinelli a, Guerra, E, Bettelli G, Cavaciocchi M. Radial head replacement with unipolar and bipolar SBi system:a clinical and radiographic analysis after a 2-year mean follow-up. Musculoskelet Surg 2012; 96:S69–S79 doi: 10.1007/s12306-012-0198-z