Mid- to long-term results after bipolar radial head arthroplasty

• Published in: Journal of shoulder and elbow surgery 2010-10, Vol.19 (7), p.965-972
• Main Authors: Burkhart, Klaus Josef, MD, Mattyasovszky, Stefan G., MD, Runkel, Martin, MD, PhD, Schwarz, Christina, Küchle, Raphael, MD, PhD, Hessmann, Martin H., MD, PhD, Rommens, Pol M., MD, PhD, Müller, Lars P., MD, PhD
• Format: Article
• Language: English
• Subjects: arthroplasty; Arthroplasty, Replacement - methods; Biological and medical sciences; capitellar erosion; complications; Diseases of the osteoarticular system; Female; fracture; Humans; instability; Joint Prosthesis; Male; Medical sciences; Orthopedic surgery; Orthopedics; Radial head; Radius Fractures - surgery; results; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Treatment Outcome
• ISSN: 1058-2746; 1532-6500
• DOI: 10.1016/j.jse.2010.05.022

Background Radial head arthroplasty is considered the treatment of choice for unreconstructable radial head fractures in the acute fracture situation. Although short-term results in the current literature are promising, replacement of the radial head remains controversial as long-term results are still missing. We report our 8.8-year results after treatment with a bipolar radial head prosthesis by Judet. Materials and methods In our department, 19 patients were treated with bipolar radial head arthroplasty between 1997 and 2001. Seventeen of these patients—14 men and 3 women—were examined retrospectively after 106 months (range, 78-139). Of these, 9 patients were treated primarily, 7 patients secondarily, and 1 because of a tumor. Results On the Mayo Elbow Performance Score, 6 patients achieved excellent results, 10 good, and one fair. The mean DASH score was 9.8 (range, 0-34). No differences were seen between primary and secondary implantation. Flexion averaged 124° (range, 110-150°), the extension deficit was 21° (range, 0-40°), pronation 64° (range, 30-90°), and supination 64° (range, 30-90°). The following complications were seen: 2 dislocations and 8 cases of degenerative changes of the capitellum, 1 with severe erosion. Signs of ulnohumeral arthrosis were found in 12 patients. No evidence of loosening, radiolucencies, or proximal bone resorption was detected. Conclusion Despite major primary complications and high incidence of radiographic signs of degenerative changes after 8.8 years, mainly good clinical results were achieved with Judet's bipolar prosthesis.