Outcomes of press-fit radial head arthroplasty following complex radial head fractures

Lobo-Escolar, Luis; Abellán-Miralles, César; Escolà-Benet, Anna

doi:10.1016/j.otsr.2020.03.031

Cited by 17 publications

(6 citation statements)

References 29 publications

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“…To our knowledge, this is the first reported case series using this implant; however, it should be noted that it is not being distributed currently for economic reasons. The revision rates are better than those previously reported for anatomic designs, 26,28,29,38 and the range of motion achieved is comparable to previous studies, 37 although the initial injury complexity is much higher.…”

Section: Discussionsupporting

confidence: 78%

Section: Discussionmentioning

confidence: 99%

“…The survivorship was found to be better when the implant was used for acute trauma rather than as a salvage procedure, but this observation may have occurred by chance; 11% of patients required removal or revision (at an average of 38.6 months postimplantation of RHP), which is better than previously reported results for press-fit RHPs. [26][27][28][29] The rate of complications for RHA is concerning, 30 but it may be related to the complexity of the associated injury. A meta-analysis of 1017 patients reported an implant removal/revision rate of 10% at a mean of 38 months follow-up.…”

Section: Discussionmentioning

confidence: 99%

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Survivorship of anatomic press-fit short-stem radial head replacement with a pyrocarbon bearing

Viswanath

Watts

2021

Shoulder & Elbow

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Background Restoring the radial head as a stabiliser of the elbow is considered important in cases where there is an associated bony or ligamentous injury. A variety of radial head prostheses are available. There are no reports of the survivorship of a short-stem press-fit radial head prostheses with pyrocarbon bearing. Patients and methods With institutional review board approval, a retrospective case-note analysis was performed of a consecutive single-surgeon case series of the Integra LifeScience pyrocarbon radial head prostheses (Carbon Modular Radial Head) from October 2010 to October 2019 in a tertiary referral centre. The series was divided into acute trauma and salvage cohorts. Kaplan–Meier survivorship analysis was conducted. Results 36 patients were included, 23 (64%) for acute injuries and 13 (36%) for failed initial treatment. Of the acute injuries, 20 (87%) had a Wrightington type-C elbow fracture-dislocation. Reoperation was performed in 4 (11%) patients; 10 (28%) had possible loosening on radiographs. The implant survival rate was 94% at shortest follow-up of 17 months (mean 70 months). Discussion Treatment of complex radial head fractures using a pyrocarbon-bearing, anatomic press-fit design provides satisfactory short-term survivorship in this case series. The implant should be used with caution in salvage cases, due to higher rates of loosening seen in this cohort.

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Section: Discussionsupporting

confidence: 78%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Survivorship of anatomic press-fit short-stem radial head replacement with a pyrocarbon bearing

Viswanath

Watts

2021

Shoulder & Elbow

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“…17 Lobo-Escolara et al in a study of 45 patients of radial head prostheses published in 2021 demonstrated a survival rate of 70% at the 2 year mark, with a complication rate of 25% for press-fit stems. 18 A recent systematic review outlined that aseptic loosening is the commonest cause for revision surgery (30%), followed by stiffness (20%), and persisting pain (17%). Press fit stems fail at a higher rate because of symptomatic loosening.…”

Section: Prosthetic Replacementmentioning

confidence: 99%

Radial head fractures

Al-Tawil

Arya

2021

Journal of Clinical Orthopaedics and Trauma

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Radial head fractures are the commonest fractures in the elbow. They are often associated with other injuries: ligamentous, cartilaginous or other fractures. Associated injuries are important determinant of the management of the radial head fracture. These should be carefully looked for, diagnosed and treated. The original Mason classification for this fracture has been modified to include the associated injuries and their treatment. CT scan is a helpful diagnostic tool and should be used if available.Radial head fractures can be treated either conservatively or operatively (by excision, open reduction and internal fixation or prosthetic replacement). Undisplaced or minimally displaced fractures should be treated non-operatively. Internal fixation by headless cannulated screws is the preferred treatment for displaced fractures. It provides satisfactory biomechanical stability, can be done through a smaller incision, has less complications and lesser requirement of later removal of screws. Small number of fractures with comminution of neck would require plate fixation. Unfixable fractures in elderly can be treated by excision while such fractures in younger population or associated with significant soft tissue or bony injuries would require prosthetic replacement.

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“…Luis Lobo-Escolar et al 1 published a study on the outcomes of press-fit radial head arthroplasty following complex radial head fractures. They had 45 patients in their study.…”

mentioning

confidence: 99%

Commentary

AlAhmadi

2021

Shoulder & Elbow

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Outcomes of press-fit radial head arthroplasty following complex radial head fractures

Cited by 17 publications

References 29 publications

Survivorship of anatomic press-fit short-stem radial head replacement with a pyrocarbon bearing

Survivorship of anatomic press-fit short-stem radial head replacement with a pyrocarbon bearing

Radial head fractures

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