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LVHN Is First in Region To Offer Newly Approved Elbow Joint Implant

Our experts contributed to the clinical trial and conducted the first surgery in May

The elbow is a tricky joint. Three bones – the humerus, radius and the ulna – come together to perform a delicate "dance" to put the hand in motion. Until recently, there weren’t any ideal options when a unique part of the elbow, the proximal radioulnar joint (PRUJ), became damaged or dislocated. Building on its success with a prosthesis closer to the wrist for the distal radioulnar joint (DRUJ), Aptis Medical created a PRUJ prosthesis for stabilization or replacement of this part of the elbow.  

Not only is Lehigh Valley Orthopedic Institute the single location in the Northeast besides Boston where PRUJ arthroplasty is available, but LVHN experts were instrumental in the device’s FDA approval.  

Arthroplasty in the cadaver lab

“The PRUJ prosthesis is especially suited for chronic dislocations and high-energy trauma to the elbow,” says Paul Sibley, DO, Chief, Division of Orthopedic Surgery, Section of Hand Surgery with Lehigh Valley Orthopedic Institute. “It is also indicated for severe PRUJ elbow arthritis, or in the setting of a failed radial head replacement, since replacing only the radial head (the outside of the elbow) can cause problems such as pain from metal on cartilage.”

According to the manufacturer, the prosthesis is “intended to relieve pain, improve grip strength, lifting capacity, flexion and extension and pronation/supination of the forearm following joint deficiency and/or instability.” Dr. Sibley sums up the device and procedure as a simple idea that “restores the elbow anatomy as it was before.”

“We brought hand surgeons from all over the region to join us the night before and hear the renowned hand surgeon, Luis Scheker, MD, speak on his history with the DRUJ and PRUJ.” - Paul Sibley, DO

Because Dr. Sibley had much success with the Aptis wrist implant, company representatives asked him to be primary investigator in the clinical trial that would prove the safety and effectiveness of the Aptis elbow prosthesis. It required a training session before the procedure was performed on a live patient. The session took place on May 21, 2025, at the Venel Institute cadaver lab, where cadavers serve as subjects for medical research.  

“We brought hand surgeons from all over the region to join us the night before and hear the renowned hand surgeon, Luis Scheker, MD, speak on his history with the DRUJ and PRUJ,” Dr. Sibley says. “It was significant moment since he is a giant in the world of hand surgery.” The following day, Dr. Sibley performed the first PRUJ implant with Dr. Scheker assisting. The surgery went well.  

First of its kind, first in the Valley

Lehigh Valley Orthopedic Institute, which ranks 20th in the nation by U.S. News & World Report and is a national destination for orthopedic care, is the first in the region to conduct this procedure. “We are continually seeking techniques that bring the highest caliber of orthopedic care to our communities,” says Thomas Graham, MD, Chief, Jefferson Orthopedics and Physician in Chief, Lehigh Valley Orthopedic Institute. “Being selected as an Institutional Review Board site speaks to the excellence of our clinicians who truly lead the way in orthopedic innovation.”

Acknowledging the impact of the device and the event, Dr. Sibley is hoping events featuring a well-known speaker and innovative procedure will become an annual event for the hand division. He is especially proud of the way hand surgeons from across the Lehigh Valley, including from competitive facilities, came together to learn about this groundbreaking medical development in PRUJ and DRUJ arthroplasty.  

“We’re pleased to be a part of FDA approval and look forward to helping more patients who have proximal radioulnar joint problems that have traditionally been difficult to treat,” Dr. Sibley says.

Lehigh Valley Orthopedic Institute

Kelsey, wrist surgery

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