Factors associated with removal of a radial head prosthesis placed for acute trauma

Causes for early and late surgical re-intervention after radial head arthroplasty

“…Our study included a large proportion of devices implanted in a delayed fashion (37.9%) and a large proportion of radial head fractures with associated lesions (65.5%) treated by bipolar implants; this was compounded by variable experience levels (specifically with RHA) of each treating surgeon at our institution. We speculate that these factors may account for the high rate of re-intervention in our cohort [15,17,32,34,35]. According to Neuhaus et al [17], 50% of RHP removals occur during the first year after surgery with a mean time to removal of 23 ± 42.25 months (0.5-144 months) [17].…”

“…We speculate that these factors may account for the high rate of re-intervention in our cohort [15,17,32,34,35]. According to Neuhaus et al [17], 50% of RHP removals occur during the first year after surgery with a mean time to removal of 23 ± 42.25 months (0.5-144 months) [17]. Our study demonstrated that it may be possible to distinguish between two periods when following results of RHA within the first three years after implantation (p < 0.001).…”

“…Although functional outcomes are promising, description and analysis of complications in the literature is sparse. The most commonly reported reason for implant failure is painful loosening [15][16][17][18][19][20].…”

Tight-fitting radial head prosthesis: does stem size help prevent painful loosening?

“…However, characteristics of the study population were not significantly different between implant groups (Table 1); most importantly, the rates of associated lesions (p = 0.69) and use of the prosthesis in a delayed or acute fashion (p > 0.38) were not different. Surgeon training in elbow surgery, particularly in RHA, was variable; which may influence results [17]. Since the mean follow-up for short-stemmed implants was less than for long-stemmed implants, the true rate of painful loosening and negative radiographic outcomes may have been lower in the short-stemmed implant group.…”

“…Radial head arthroplasty (RHA) bas satisfactory out cornes according to recent Iiterature [5][6][7][8]; however, tight fitting radial head prostheses (RHP) may have inferior rnid term survival than loose-fitting implants [5][6][7][8][9][10][11][12][13][14]. High compli cation rates have been reported after this procedure, and the most common cause of RHP removal is painful prosthetic loosening [15][16][17][18][19]. O'Driscoll and colleagues [20,21] identi fied several mechanical mies to follow to obtain a well-fixed implant while rninirnising micromotion, with stem diameter and length being the most important factors.…”