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Aims The aim of this study was to analyze the results of two radiocapitellar prostheses in a large case series followed prospectively, with medium-term follow-up. Patients and Methods A total of 31 patients with a mean age of 54 years (27 to 73) were analyzed; nine had primary osteoarthritis (OA) and 17 had post-traumatic OA, three had capitellar osteonecrosis, and two had a fracture. Overall, 17 Lateral Resurfacing Elbow (LRE) and 14 Uni-Elbow Radio-Capitellum Implant (UNI-E) arthroplasties were performed. Pre- and postoperative assessment involved the Mayo Elbow Performance Score (MEPS), the Quick Disabilities of the Arm, Shoulder and Hand (Q-DASH) score, and the modified American Shoulder Elbow Surgeons (m-ASES) score. Results The mean follow-up was 6.8 years (3.8 to 11.5). The mean MEPS, m-ASES, and Q-DASH scores improved significantly by 50 (p < 0.001), 55 (p < 0.001), and 54 points (p < 0.001), respectively, with no differences being detected between the implants. Preoperative pronation and supination were worse in patients in whom the UNI-E was used. Two patients with the UNI-E implant had asymptomatic evidence of gross loosening. Conclusion Radiocapitellar arthroplasty yielded a significant improvement in elbow function at a mean follow-up of 6.8 years, with a high implant survival rate when the LRE was used in patients with primary or post-traumatic OA, without radial head deformity, and when the UNI-E was used in patients in whom radial head excision was indicated. Cite this article: Bone Joint J 2019;101-B:1362–1369

the ulna and the humerus in 1 case each. There were 25 pin-site infections, of which 10 required resetting of fixator pins and 15 resolved by intensive pin site care and antibiotic treatment. There were no complications to the radial nerve and 8 postoperative surgery related ulnar neuropathies (PSRUN) in the severe posttraumatic elbow stiffness group, requiring in situ neurolysis of the ulnar nerve. The overall functional result was excellent.Conclusions: Hinged elbow fixations is a safe, reliable and versatile surgical tool in complex elbow trauma and posttraumatic elbow reconstruction with a very low fixatorrelated complication rate in specialized elbow centers with elaborated teaching programs and a functioning aftercare unit but may belong in these centers.