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Anterior radial head subluxation in primary elbow osteoarthritis

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Abstract

Purpose

To investigate elbows with primary osteoarthritis (OA) for the presence of anterior radial head subluxation.

Methods

A total of 71 patients with elbow osteoarthritis and 45 with lateral epicondylitis were initially identified. The baseline characteristics and preoperative elbow X-rays of consecutive patients that had been clinically confirmed with elbow OA or lateral epicondylitis between March 2011 and January 2020 were then retrospectively reviewed. The radiocapitellar ratio (RCR; the ratio of the displacement of the radial head about the diameter of the capitulum) was calculated using lateral views. These RCR values were compared between the OA and lateral epicondylitis cases.

Result

A significant increase was detected in RCR values between patients in elbow OA and the control group (13.2% (± 10.6) vs −1.2% (± 6.8), P<0.001). Based on receiver operating characteristic curves, RCR values had an excellent area under the curve (0.89) for the detection of elbow OA (Youden index, 0.69; sensitivity, 89%; specificity, 80%). Based on the ROC curve, the cutoff value of RCR was 0.04. Patients with RCR ≥ 0.04 had a significantly higher proportion of cases with elbow OA (risk ratio, 31.50 [95% CI, 11.17–88.82]) than those with RCR ˂ 0.04 (P ˂ 0.001).

Conclusion

Radial head subluxation is a radiographic finding associated with elbow OA and RCR ≥ 0.04 could be used as an aetiological factor for elbow OA diagnosis.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea

    Hui Ben, Kyoung-Hwan Koh & In-Ho Jeon

  2. Department of Orthopedic Surgery, Uijeongbu Eulji Medical Center, Eulji University College of Medicine, Uijeongbu-si, Gyeonggi-do, South Korea

    Jae-Man Kwak

  3. Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea

    Chu Hui Zeng

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Contributions

Hui Ben: conceptualization, investigation, methodology, writing—original draft

Jae-Man Kwak and Chu Hui Zeng: data curation, methodology, writing—review and editing

Kyoung-Hwan Koh: supervision, visualization, writing—review and editing

In-Ho Jeon: conceptualization, methodology, project administration, supervision, writing—review and editing

Corresponding author

Correspondence to In-Ho Jeon.

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Ben, H., Kwak, JM., Zeng, C.H. et al. Anterior radial head subluxation in primary elbow osteoarthritis. International Orthopaedics (SICOT) 48, 809–815 (2024). https://doi.org/10.1007/s00264-023-06059-3

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  • DOI: https://doi.org/10.1007/s00264-023-06059-3

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