Radial Head Replacement for Acute Complex Fractures: What Are the Rate and Risks Factors for Revision or Removal?

Duckworth, Andrew D.; Wickramasinghe, Neil R; Clement, Nicholas D.; Court-Brown, Charles M.; McQueen, Margaret M.

doi:10.1007/s11999-014-3516-y

Cited by 97 publications

(57 citation statements)

References 41 publications

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“…While no previous studies have described outcomes after removal of failed radial head arthroplasty, short-to intermediate-term follow up after arthroplasty for radial head fracture has generally demonstrated favorable results [3] [7] [8] [9] [16]. Risk factors for failure after radial head arthroplasty include acute unstable fractures, younger patient age, silastic implant, and technical errors in implant placement such as overstuffing [13] [16].…”

Section: Discussionmentioning

confidence: 99%

“…Risk factors for failure after radial head arthroplasty include acute unstable fractures, younger patient age, silastic implant, and technical errors in implant placement such as overstuffing [13] [16]. Surgical options for failed radial head arthroplasty generally involve revision versus implant removal.…”

Section: Discussionmentioning

confidence: 99%

“…Failure after radial head arthroplasty can occur for various reasons including pain, stiffness, and instability [13]. Risk factors for failure after radial head arthroplasty include acute unstable fractures, younger patient age, silastic implant, and technical errors in implant placement [13] [16]. Treatment for failed radial head arthroplasty may entail either revision or removal of the implant.…”

Section: Introductionmentioning

confidence: 99%

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Clinical Outcome for Failed Radial Head Arthroplasty Treated with Explantation

Holt¹,

Struk²,

King³

et al. 2017

OJO

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Purpose: Failure after radial head arthroplasty is uncommon, but clinically significant. Treatment for failure may involve implant removal. We describe fourteen patients who underwent implant removal after failed radial head arthroplasty. Methods: A retrospective review was performed to determine the cause of failure and clinical data were prospectively collected. Results: At mean follow up of 38 months the mean VAS for pain score was 3.0 and the mean DASH score was 40.5. The mean MEPS was 69. All patients demonstrated improved elbow range of motion. Mean elbow flexion at final follow up was 124˚ to an average extension deficit of 25˚. Fifty percent of patients exhibited clinical symptoms of cubital tunnel syndrome. Three patients required additional surgery after implant removal. Conclusions: Implant removal for failed radial head arthroplasty improves range of motion and demonstrates acceptable outcomes at intermediate-term follow up. However, 50% of patients developed cubital tunnel syndrome and 21% required revision surgery.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Clinical Outcome for Failed Radial Head Arthroplasty Treated with Explantation

Holt¹,

Struk²,

King³

et al. 2017

OJO

View full text Add to dashboard Cite

show abstract

“…In a report by Duckworth et al 11% had a radial head replacement removed due to stiffness with or without pain (Duckworth et al 2014).…”

Section: Stiffness-heterotopic Bone Formation (Ho) Fig 32mentioning

confidence: 99%

“…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.…”

Section: Instabilitymentioning

confidence: 99%

Arthroplasty in Elbow Fracture Treatment

Nestorson¹

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Radial head arthroplasty diameter impact on elbow kinematics evaluated by dynamic radiostereometric analysis

Teilmann,

Petersen,

Thillemann

et al. 2024

J. exp. orthop.

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PurposeRadial head arthroplasty (RHA) reestablishes elbow stability after complex radial head fracture, but complication rates are high, possibly due to inappropriate implant sizing. Knowledge of impact of radial head implant diameter on elbow kinematics is limited and warranted. This study evaluated elbow kinematics of different radial head implant diameters after RHA using dynamic radiostereometric analysis (dRSA).MethodsEight human donor arms were examined with dRSA during elbow flexion with the forearm in unloaded neutral position, and in supinated‐ and pronated position without and with 10N either varus or valgus load, respectively. Elbow kinematics were examined before and after RHA with head diameters of anatomical size, −2 mm (undersized), and +2 mm (oversized). The ligaments were kept intact by use of step‐cut humerus osteotomy for repeated RHA exchange. Bone models were obtained from CT, and by AutoRSA software bone models were matched with dRSA recordings. The elbow kinematics were described using anatomical coordinate systems.ResultsCompared to the native radial head during elbow flexion, the anatomical sized RHA shifted 2.0 mm in ulnar direction during unloaded pronated forearm position. The undersized RHA shifted 1.5 mm in posterior direction and 2.1 mm in ulnar direction during unloaded pronated forearm position and increased the varus angle by 2.4° during supinated loaded forearm position. The oversized RHA shifted 1.6 mm in radial direction during loaded supinated forearm position.ConclusionsThe anatomically sized RHA should be preferred as it maintained native elbow kinematics the best. The kinematic changes with oversized and undersized RHA diameters were small, suggesting forgiveness for the RHA diameter size.Level of EvidenceLevel III.

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Radial Head Replacement for Acute Complex Fractures: What Are the Rate and Risks Factors for Revision or Removal?

Abstract: Level IV, therapeutic study. See Instructions for Authors for a complete description of levels of evidence.

Cited by 97 publications

References 41 publications

Clinical Outcome for Failed Radial Head Arthroplasty Treated with Explantation

Clinical Outcome for Failed Radial Head Arthroplasty Treated with Explantation

Arthroplasty in Elbow Fracture Treatment

Radial head arthroplasty diameter impact on elbow kinematics evaluated by dynamic radiostereometric analysis

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