Outcomes of bipolar radial head prosthesis to treat complex radial head fractures in 22 patients with a mean follow-up of 50 months

Abstract

IV, retrospective study.

Arthroplasty in Elbow Fracture Treatment

“…The mean MEPS was 79, quick-DASH score 21, and 3 patients had residual postero-lateral instability, and four implants had been removed during the observation time (Allavena et al 2014).…”

“…Using a design with a stem that is meant to be fixed in the proximal radius medullary canal (press-fit) Flinkkila et al reported a loosening rate of 32% and 24% of the implants had to be removed (Flinkkila et al 2012), fig 37. Allavena et al, using a bi-polar implant with a fixed stem, reported 41% with signs of loosening and 18% of implants required removal (Allavena et al 2014).…”

“…Some authors recommend radial head arthroplasty for all fractures that are not amenable for conservative treatment or ORIF, so as to reduce the risk for future instability and proximal migration of the radius (Ruchelsman et al 2013, Allavena et al 2014, Duckworth et al 2014, Heijink et al 2016.…”

“…No series with such a long follow-up after radial head replacement is available but secondary osteoarthritis in the ulno-humeral joint has been reported in several publications using different implant designs (Grewal et al 2006, Doornberg et al 2007a, Marsh et al 2016. Attrition of the capitellum has also been reported, in some cases associated with lateral elbow pain necessitating removal of the implant (Flinkkila et al 2012, Allavena et al 2014, Marsh et al 2016.…”

“…This emphasises the importance of lateral ligament repair. Ulno-humeral osteoarthritis has been seen in 27-50% of patients treated with radial head replacement and reoperation rates range from 4-31% (Flinkkila et al 2012, Allavena et al 2014, Marsh et al 2016. Prosthetic loosening is a frequent indication for secondary surgery.…”