• K Wegmann, M Hackl, T Leschinger, K J Burkhart, and L P Müller.
• Faculty of Medicine and University Hospital, Center for Orthopedic and Trauma Surgery, University Medical Center of Cologne, Kerpener Street 62, 50937, Cologne, Germany. Kilian.Wegmann@uk-koeln.de.
• Arch Orthop Trauma Surg. 2021 Sep 1; 141 (9): 1525-1539.

BackgroundRadial head arthroplasty is a common procedure in elbow surgery. It has been shown to be of benefit for the patients, but there also are relevant complications that should be prevented if possible. One significant complication is overlengthening of the radial head prosthesis. In overlengthening, the head of the prosthesis overextends the physiological level of the native radial head and leads to overcompression in the radiohumeral joint. Rapid erosion and arthritic changes may then impede the clinical outcome. The incidence of overlengthening is not precisely known, but estimations range to up to 20% of all implanted prostheses.MethodsThe present review discusses the available body of literature on overlengthening and lines out a classification system that may be used to guide treatment algorithms. The classification is based on the personal experiences of the author during their clinical practice.ResultsIn low-grade overlengthening (type I) conservative treatment can be an option. In Types II-IV usually revision surgery is needed. Depending on the state of the capitulum and joint stability, it is possible re-implant a prosthesis, or rely on implant removal alone.DiscussionThe present review aimed at shedding light into overlengthening as a complication radial head replacement and to help identify and treat it.© 2020. The Author(s).

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