Radial head arthroplasty, 11 years experience: A series of 82 patients

• Published in: Revista española de cirugía ortopédica y traumatología 2015-09, Vol.59 (5), p.307-317
• Main Authors: Contreras-Joya, M, Jiménez-Martín, A, Santos-Yubero, F J, Navarro-Martínez, S, Najarro-Cid, F J, Sánchez-Sotelo, J, Pérez-Hidalgo, S
• Format: Article
• Language: English
• Subjects: Adult; Arthroplasty, Replacement, Elbow - instrumentation; Arthroplasty, Replacement, Elbow - methods; Elbow Joint - injuries; Elbow Joint - surgery; Elbow Prosthesis; Female; Follow-Up Studies; Hemiarthroplasty - instrumentation; Hemiarthroplasty - methods; Humans; Male; Middle Aged; Radius Fractures - surgery; Retrospective Studies; Treatment Outcome
• ISSN: 1988-8856; 1988-8856
• DOI: 10.1016/j.recote.2015.07.008

The indications for radial head arthroplasty are essentially complex fractures with ligament damage (medial, lateral or Essex-Lopresti), and/or associated with bone damage (coronoids or olecranon). The aim of this study is to review our experience with the use of a radial head prosthesis in the context of a trauma. An observational, descriptive and retrospective study, with a follow-up of 1- 11 years, was performed on a study group of 82 patients with a mean age of 41.6 (± 9.2) years. The inclusion criteria were: patients of working age (25-64 years) with complex radial head fractures (Mason II, III, IV), with soft tissue and bone injuries that caused instability, non-reconstructable by osteosynthesis and treated using arthroplasty. The primary variables analysed were social demographics, Mason classification, or surgical aspects such as delay, surgical time, type of prosthesis (where the bipolar prosthesis was most used, 88.6%), need of fixation or further surgery. Rehabilitation time, causes of prosthesis failure, radiological findings (according to Van-Riet), areas of loosening (according to Popovic), as well as the Mayo Elbow Performance Score (MEPS) and the Cassebaum scale. Various associated injuries were observed, such as injuries in the lateral collateral ligament of the elbow in 39% of cases, coronoid fractures in 25.6%, and an olecranon fracture in 15.9% of the series. There was one case of an Essex- Lopresti injury. The tests used for the statistical analysis were Chi squared and Fisher test for categorical variables and contingency tables. The Mann Whitney U or Kruskall Wallis tests were used for the numerical variables. Evidence level: IV. The mean surgical time was 100 (± 56.8) minutes. The prosthesis was fixed in 53.8% of cases. The mean score on the MEPS scale was 80.4 (± 19.3) points, being good-excellent in 71.6%. The elbow was stable in 93.7% of cases. There was moderate instability, with 10° or more in varus or valgus, and in 1.3% in the rest of the series. The rehabilitation time was lower in the fixed cases (P=.03), and there was greater rigidity (P=.03) and more sequelae (limitations in mobility, residual pain), (P