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Kang J, Demaria S, Cardenes H, Pilones K, Jozsef G, Ng J, Ballman K, Formenti S. Effect of Radiotherapy Variables on Circulating Effectors of Immune Response. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.1684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Gracia PV, Caballero LC, Sánchez J, Espinosa J, Campana S, Quintero A, Luo C, Ng J. Pregnancies recovered from SARS-CoV-2 infection in second or third trimester: obstetric evolution. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2020; 56:777-778. [PMID: 32996648 PMCID: PMC7537281 DOI: 10.1002/uog.23134] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 09/16/2020] [Accepted: 09/18/2020] [Indexed: 05/23/2023]
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Kaylor K, Fecteau R, Pennell R, Chen S, Balogun O, Cardenes H, Golden E, Ng J. Initial Outcomes And Treatment-Associated Toxicities Using Stereotactic MRI-Guided Adaptive Radiation Therapy For Pancreatic Cancer Patients Treated At A Single Institution. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.1872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Ng J, Rajput A, Ng Q, Sarkar A. PCN56 Addressing the Credibility GAP of Real-World Evidence Generation in Southeast ASIA: An Analysis of 200 Articles over 10 YEARS. Value Health Reg Issues 2020. [DOI: 10.1016/j.vhri.2020.07.106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Thompson J, Ng J, Armstrong B, Feletto E, Ha T. Differences in Colorectal Cancer (CRC) patients who did and did not undergo screening. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa165.1343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
The Australian National Bowel Cancer Screening Program (NBSCP) is a free population-based screening program which aims to identify precancerous lesions and early colorectal cancer (CRC) using an immunochemical faecal occult blood test in average risk Australians. Formally commencing in 2006, NBCSP participation rate in eligible 50-74-year-old people was 42% in 2018. The barriers and facilitators of participation in the NBCSP have been explored for the general, at-risk population but not in a population of CRC patients. This is the first study to assess a population of CRC patients, post diagnosis, who would have been eligible for CRC screening to determine the barriers and facilitators to screening.
Methods
A cross sectional study nested within a cohort study. Data from CRC patients who participated in the 45 and Up Study; the largest cohort study in Australia and southern hemisphere, were analysed to compare those who had and had not participated in CRC screening. Logistic regression analyses were conducted using RStudio (version 3.5.2, Boston, Massachusetts, USA.). Multiple Imputation (MI), was used to handle missing values assumed to be missing at random.
Results
A total of 339 CRC patients were included. Patients who were female, overweight (≥25kg/m2), consumed less than the recommended five servings of vegetables per day, consumed less than or equal to fourteen standard drinks per week (compared to non-drinkers) or did not meet physical activity guidelines were significantly less likely to have participated in screening.
Conclusions
Our study has taken a unique approach to identifying a high-risk group by exploring factors to screening participation in CRC patients. CRC patients with less healthy lifestyles were less likely to participate in screening. In contrast to previous studies, female patients were less likely to participate in screening than males were. This was an unexpected finding and should be replicated.
Key messages
Not surprising that those with less healthy lifestyle practices also reflected less than ideal screening practices. Surprising that female patients participated less in screening than males. Future interventions to improve CRC screening participation rates should consider specialised messaging for average-risk females who are overweight not meeting dietary or physical activity guidelines.
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Kravvas G, Ge L, Ng J, Shim TN, Doiron PR, Watchorn R, Kentley J, Panou E, Dinneen M, Freeman A, Jameson C, Haider A, Francis N, Minhas S, Alnajjar H, Muneer A, Bunker CB. The management of penile intraepithelial neoplasia (PeIN): clinical and histological features and treatment of 345 patients and a review of the literature. J DERMATOL TREAT 2020; 33:1047-1062. [DOI: 10.1080/09546634.2020.1800574] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Chen LJ, Wang S, Le Contel O, Rager A, Hesse M, Drake J, Dorelli J, Ng J, Bessho N, Graham D, Wilson LB, Moore T, Giles B, Paterson W, Lavraud B, Genestreti K, Nakamura R, Khotyaintsev YV, Ergun RE, Torbert RB, Burch J, Pollock C, Russell CT, Lindqvist PA, Avanov L. Lower-Hybrid Drift Waves Driving Electron Nongyrotropic Heating and Vortical Flows in a Magnetic Reconnection Layer. PHYSICAL REVIEW LETTERS 2020; 125:025103. [PMID: 32701350 DOI: 10.1103/physrevlett.125.025103] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 06/11/2020] [Indexed: 06/11/2023]
Abstract
We report measurements of lower-hybrid drift waves driving electron heating and vortical flows in an electron-scale reconnection layer under a guide field. Electrons accelerated by the electrostatic potential of the waves exhibit perpendicular and nongyrotropic heating. The vortical flows generate magnetic field perturbations comparable to the guide field magnitude. The measurements reveal a new regime of electron-wave interaction and how this interaction modifies the electron dynamics in the reconnection layer.
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Smith-Gorvie T, Nyhof-Young J, Ng J, D'Urzo T, Katzman D. Medical student perceptions of research training on patient care during clerkship. MEDEDPUBLISH 2020; 9:107. [PMID: 38073812 PMCID: PMC10702863 DOI: 10.15694/mep.2020.000107.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2023] Open
Abstract
This article was migrated. The article was marked as recommended. Background Health Science Research (HSR) is a pre-clerkship component of the University of Toronto (U of T) MD Program. Through online modules and tutorials, students learn to understand and apply research, and write an original research protocol. This study explored students' perceptions on how HSR prepared them to identify, critically appraise and consume research during clerkship. Methods An online 12-item questionnaire surveyed U of T medical students (Class of 2018) who completed HSR in 2016. Basic descriptive statistics were performed; free text responses were analysed via descriptive thematic analysis. Results Twenty six percent (67/262) of students participated. Approximately half either agreed/strongly agreed that HSR helped them to critically appraise research articles (50.7%, 32/63) and assess applicability of results to patient care (50.8%, 32/63). Three themes emerged: i) desire for increased critical appraisal, ii) producing research less important than consuming research, iii) developing a greater appreciation of research during clerkship. Conclusions Students' perceptions on HSR's value during clerkship were modest; they desired greater focus on learning to be consumers of research. These results will refine HS, and our observations may be useful to other educators, as this type of intervention is not represented in existing literature.
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Chiew G, Ng J, Lim J, Nguyen T, Fu B, Lin X. Large scale 3D bioreactor technology: linear scale up of mesenchymal stromal cell expansion with tidexcell™ system. Cytotherapy 2020. [DOI: 10.1016/j.jcyt.2020.03.314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Prasath A, Ho A, Ng J, Lin PY, Yang KL. Discovery of a novel HLA-A*02 variant, HLA-A*02:402, in a Singaporean cord blood unit. HLA 2020; 96:205-206. [PMID: 32167234 DOI: 10.1111/tan.13860] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 03/09/2020] [Accepted: 03/09/2020] [Indexed: 11/28/2022]
Abstract
Nucleotide replacements in codons 145 and 149 of HLA-A*02:03:01 result in a new allele, HLA-A*02:402.
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Ng J, Martinez RS, Martinez S. Focus on Faculty: A Missing Link in Community–University Partnerships. JOURNAL OF EDUCATIONAL AND PSYCHOLOGICAL CONSULTATION 2020. [DOI: 10.1080/10474412.2020.1726765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Ng J. Web Exclusive. Annals Graphic Medicine - W.O.W. Ann Intern Med 2020; 172:W38. [PMID: 31958839 DOI: 10.7326/g19-0017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Ng J. Web Exclusive. Annals Graphic Medicine - Fear and Loathing in RA. Ann Intern Med 2019; 171:W78. [PMID: 31766055 DOI: 10.7326/g19-0013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Egedal J, Ng J, Le A, Daughton W, Wetherton B, Dorelli J, Gershman D, Rager A. Pressure Tensor Elements Breaking the Frozen-In Law During Reconnection in Earth's Magnetotail. PHYSICAL REVIEW LETTERS 2019; 123:225101. [PMID: 31868399 DOI: 10.1103/physrevlett.123.225101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 08/22/2019] [Indexed: 06/10/2023]
Abstract
Aided by fully kinetic simulations, spacecraft observations of magnetic reconnection in Earth's magnetotail are analyzed. The structure of the electron diffusion region is in quantitative agreement with the numerical model. Of special interest, the spacecraft data reveal how reconnection is mediated by off-diagonal stress in the electron pressure tensor breaking the frozen-in law of the electron fluid.
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Ngoi N, Heong V, Kumarakulasinghe N, Phyu P, Peh E, Lim S, Lim Y, Tang J, Choo B, Koh V, Ilancheran A, Low J, Ng J, Thian Y, Tan D. Phase I study of low dose whole abdominal radiation therapy (LDWART) in combination with weekly paclitaxel (wP) for platinum resistant ovarian cancer (PROC). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz250.040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Wyrwicz L, Saunders M, Hall M, Ng J, Prasad VB, Lautermilch N, Rashford M, Jin J, Formenti S, Glynne-Jones R. A phase Ib study of E7046 (AN0025) in combination with radiotherapy/chemoradiotherapy (RT/CRT) in preoperative treatment of rectal cancer. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz246.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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James DA, Ng J, Wei J, Vandemeulebroecke M. Multistate modeling and simulation of patient trajectories after allogeneic hematopoietic stem cell transplantation to inform drug development. Biom J 2019; 61:1303-1313. [PMID: 30295953 PMCID: PMC7074899 DOI: 10.1002/bimj.201700285] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Revised: 07/26/2018] [Accepted: 07/31/2018] [Indexed: 11/09/2022]
Abstract
We present a case study for developing clinical trial scenarios in a complex progressive disease with multiple events of interest. The idea is to first capture the course of the disease in a multistate Markov model, and then to simulate clinical trials from this model, including a variety of hypothesized drug effects. This case study focuses on the prevention of graft-versus-host disease (GvHD) after allogeneic hematopoietic stem cell transplantation (HSCT). The patient trajectory after HSCT is characterized by a complex interplay of various events of interest, and there is no established best method of measuring and/or analyzing treatment benefits. We characterized patient trajectories by means of multistate models that we fitted to a subset of the Center for International Blood and Marrow Transplant Research (CIBMTR) database. Events of interest included acute GvHD of grade III or IV, severe chronic GvHD, relapse of the underlying disease, and death. The transition probability matrix was estimated using the Aalen-Johansen estimator, and patient characteristics were identified that were associated with different transition rates. In a second step, clinical trial scenarios were simulated from the model assuming various drug effects on the background transition rates, and the operating characteristics of different endpoints and analysis strategies were compared in these scenarios. This helped devise a drug development strategy in GvHD prevention after allogeneic HSCT. More generally, multistate models provide a rich framework for exploring complex progressive diseases, and the availability of a corresponding simulation machinery provides great flexibility for clinical trial planning.
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Fecteau R, Pennell R, Farjam R, Ng J. Initial Dosimetric Outcomes and Treatment Related Toxicities Using Stereotactic MRI-Guided Radiation Therapy (SMART) for Unresectable Pancreatic Cancer at a Single Institution. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.2008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Broad JB, Wu Z, Ng J, Arroll B, Connolly MJ, Jaung R, Oliver F, Bissett IP. 79USE OF BIG DATA TO GUIDE RESEARCH DIRECTIONS IN DIVERTICULAR DISEASE OF THE INTESTINES (DDI): PRIMARY CARE MANAGEMENT OF DDI IS COMMON, YET EVIDENCE IS LACKING AND GUIDELINES ARE SILENT. Age Ageing 2019. [DOI: 10.1093/ageing/afz060.01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Tang J, Heong V, Ng J, Low J, Tan D. Use of low-dose whole abdominal radiation therapy (LDWART) as a chemosensitizer in combination with weekly paclitaxel for platinum-resistant ovarian cancer: Safety analysis. Gynecol Oncol 2019. [DOI: 10.1016/j.ygyno.2019.04.404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Marson BA, Ng J, Myint Y, Grindlay D, Ollivere BJ. Management of 'low-risk' ankle fractures in children: a systematic review. Ann R Coll Surg Engl 2019; 101:539-545. [PMID: 30855167 DOI: 10.1308/rcsann.2019.0027] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION This study aimed to review the literature to establish whether there is a best treatment for low-risk ankle fractures in children. MATERIALS AND METHODS A systematic review and meta-analysis of trials was undertaken, which compared interventions for 'low-risk' ankle fractures in children. A meta-analysis was performed using a random effects model. RESULTS Four trials were identified reporting outcomes from 256 patients. All trials reported results using a device that permitted ankle motion compared with more rigid immobilisation. Overall risk of bias was low for three trials and high for one trial. Two trials assessed time to return to normal function. Patients treated in a splint or with a bandage recovering 6-7.5 days sooner than those treated with rigid immobilisation. One trial demonstrated that children returned to school sooner if treated in a bandage rather than in a cast. Two trials found a higher Activity Scale for Kids performance score at four weeks for children treated with splint compared with rigid immobilisation. There was no clear advantage to any device in patient satisfaction, quality of life or total costs. DISCUSSION There is no clear best treatment for these injuries. Studies had significant limitations and outcomes were heterogeneous, limiting meta-analysis. CONCLUSION There is a need for a definitive trial to establish the best treatment for ankle fractures and a core outcome set to ensure study findings are consistent and can be analysed in future meta-analyses.
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Stevens EM, Frank D, Codispoti M, Kypriotakis G, Cinciripini PM, Claiborne K, Deweese MM, Engelmann JM, Green CE, Karam-Hage M, Minnix JA, Ng J, Robinson JD, Tyndale RF, Vidrine DJ, Versace F. The Late Positive Potentials Evoked by Cigarette-Related and Emotional Images Show no Gender Differences in Smokers. Sci Rep 2019; 9:3240. [PMID: 30824792 PMCID: PMC6397300 DOI: 10.1038/s41598-019-39954-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Accepted: 02/05/2019] [Indexed: 12/02/2022] Open
Abstract
When trying to quit, women are less likely than men to achieve long-term smoking abstinence. Identifying the neuropsychological mechanisms underlying women's higher relapse vulnerability will help clinicians to develop effective tailored smoking cessation interventions. Here we used event-related potentials (ERPs), a direct measure of brain activity, to evaluate the extent to which neurophysiological responses to cigarette-related and other emotional stimuli differ between female and male smokers. Both women and men showed similar patterns of brain reactivity across all picture categories; pleasant and unpleasant images prompted larger Late Positive Potentials (LPPs, a robust measure of motivational relevance) than neutral images in both groups, and cigarette-related images prompted lower LPPs than high arousing emotional images in both groups. Unlike previous studies, there were no differences between male and female smokers with regard to LPP responses to cigarette-related images. This suggests that the LPP may not be ideally suited to discriminate neurophysiological gender differences or that there are simply no gender differences in the neurophysiological responses to cigarette-related stimuli. We collected ERPs from 222 non-nicotine-deprived smokers (101 women) while they watched a slideshow that included high and low emotionally arousing pleasant and unpleasant pictures, cigarette-related, and neutral pictures. We used the mean amplitude of the LPP to assess the affective significance that participants attributed to these pictures.
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Tönshoff B, Ettenger R, Dello Strologo L, Marks SD, Pape L, Tedesco-Silva H, Bjerre A, Christian M, Meier M, Martzloff ED, Rauer B, Ng J, Lopez P. Early conversion of pediatric kidney transplant patients to everolimus with reduced tacrolimus and steroid elimination: Results of a randomized trial. Am J Transplant 2019; 19:811-822. [PMID: 30125462 DOI: 10.1111/ajt.15081] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 07/25/2018] [Accepted: 08/12/2018] [Indexed: 01/25/2023]
Abstract
In a 12-month, multicenter, open-label study, 106 children were randomized at 4 to 6 weeks after kidney transplantation to switch to everolimus with reduced TAC (EVR/rTAC) and steroid elimination from month 5 posttransplant or to continue standard tacrolimus with mycophenolate mofetil (sTAC/MMF) and steroids. The cumulative incidence of a co-primary efficacy end point (biopsy-proven acute rejection [BPAR], graft loss, or death from randomization to month 12) was 10.3% with EVR/rTAC and 5.8% with sTAC/MMF (difference 4.4%; P = .417). BPAR occurred in 9.6% and 5.6% of patients, respectively. Patient and renal allograft survival were 100%. The co-primary end point of mean estimated glomerular filtration rate at month 12 was 76.2 mL/min/1.73 m2 with EVR/rTAC and 72.5 mL/min/1.73 m2 for sTAC/MMF (difference 3.8 mL/min/1.73m2 ; P = .49). One EVR/rTAC patient developed posttransplant lymphoproliferative disease. Longitudinal growth and sexual maturation were equivalent between groups. The randomized drug regimen was discontinued in 34.6% and 13% of patients in the EVR/rTAC and sTAC/MMF groups, respectively (P = .024), and discontinued due to adverse events/infections in 25.0% and 11.1% of patients (P = .062). In conclusion, early conversion of pediatric kidney transplant patients from TAC, MMF, and steroids to EVR/rTAC and steroid withdrawal maintains immunosuppressive efficacy and preserves renal function.
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Mackintosh D, Islam MF, Ng J, Basham J. Immune checkpoint inhibitor use in antisynthetase syndrome. Asia Pac J Clin Oncol 2019; 15:266-269. [PMID: 30815986 DOI: 10.1111/ajco.13141] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Accepted: 02/12/2019] [Indexed: 11/26/2022]
Abstract
We report on the unique case of a patient with antisynthetase syndrome and metastatic non-small cell lung cancer undergoing therapy with the PD-1 checkpoint inhibitor, nivolumab. Despite adequate autoimmune disease control over a period of 12 months, the patient rapidly experienced a flare of interstitial lung disease following initial nivolumab administration, which ultimately proved fatal. The use of immune checkpoint inhibitors in patients with autoimmune disease is becoming more commonplace, however this is the first reported case of the use of these agents in a patient with antisynthetase syndrome. Additionally, the patient's initial clinical presentation with antisynthetase syndrome and simultaneous primary lung cancer, a rare association of which there are few case reports, makes this case interesting and unusual.
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Berkmortel CJ, Gladwell MS, Ng J, Ferreira LM, Athwal GS, Johnson JA, King GJW. Effect of Radial Neck Length on Joint Loading. J Shoulder Elb Arthroplast 2019. [DOI: 10.1177/2471549219829964] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Introduction: Load transfer across the radiocapitellar joint of the elbow is poorly understood both in the setting of the native radial head and following radial head arthroplasty. The purpose of this in vitro study was to determine the effects of radial neck length, arm position, and lateral collateral ligament (LCL) repair on radial load.Methods: A uniaxial load cell was implanted into the radial neck of 8 cadaveric specimens that were mounted on an in vitro motion-control simulator and tested (in dependent, varus, and valgus arm orientations) with the native radial neck length and then −4 to +4 mm lengths. Testing was performed with the LCL intact and after sectioning and repair.Results: There was no significant difference between the 2 LCL states (P = .82), and LCL state was not protective of proximal radius overlengthening. Radial loads increased with increasing radial length (P < .001).Discussion and Conclusion: Overlengthening the radial neck resulted in higher compression forces, and underlengthening produced tensile forces, demonstrating that restoration of correct radial length during radial head arthroplasty is important to restore physiologic loading. In the varus position, tensile loading occurred, which may explain clinical problems with ingrowth of uncemented radial head implant stems and dissociation of bipolar implants.
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