Technique for three-dimensional assessment of prosthesis alignment after radial head arthroplasty: A technical note

Objective: To present a novel evaluation technique for assessing three-dimensional (3D) prosthesis alignment after radial head arthroplasty (RHA) and to identify potential measurement errors associated with this method. Materials/Methods: Virtual surgical planning of a simulated irreparable fracture of the radial head was performed to select and place optimal implants. Of the six 3D-printed bone models, three were fitted with 3D-printed implants and three with metallic implants. After the procedure, 3D models were derived from 3D scans and dual-energy computed tomography with and without metal artifact reduction. Deviations in rotation and translation from the pre-procedure plan as well as measurement errors were assessed. Results: The technique demonstrated the ability to accurately identify minor deviations in prosthesis alignment post-RHA. Deviations ranged from 0 to 14° in rotation and 0 to 1.3 mm in translation. The method also showed high measurement accuracy against 3D reference models, with mean rotational errors of 0.3–0.5° and translation errors of 0.1–0.3 mm. Conclusion: This technique provides an accurate and precise method for assessing prosthesis alignment in RHA, with minimal measurement errors. Its potential as a valuable clinical tool has substantial implications in improving preoperative planning and postoperative evaluation. Further validation and advancements in reducing operator dependency are necessary for clinical adoption.