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Cemented radial head arthroplasty: Does radiographic loosening have an effect on clinical and functional outcomes? Average 10 years’ results

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Abstract

Purpose

The aim of this study was to evaluate the possible effect of radiographic loosening on clinical and functional outcomes, while presenting the mid-term radiographic and functional outcomes of cemented, monopolar RHA applied to patients with comminuted radial head fractures.

Methods

We performed a retrospective study by evaluating the records of patients who were diagnosed in a single center with radial head fractures between 2001 and 2013. Twenty-six patients with comminuted radial head fractures with a mean age of 48.9 and a mean follow-up time of 132.2 months were included. The radiographic evaluation was performed by assessing peri-prosthetic radiolucent lines around the stem to evaluate loosening, while the clinical evaluation was performed by utilizing elbow range of motion (ROM), Mayo elbow performance score (MEPS), Oxford elbow score (OES) and quick-DASH scores.

Results

13 patients (Group 1) with peri-prosthetic stem lucency were defined as radiographic loosening (50%), while the remaining 13 patients (Group 2) were not detected to have stem lucency. One patient in group 1 also had concomitant pain and underwent removal of the prosthesis, while 12 patients (92.3%) remained pain-free. On the latest follow-up visit, there was no significant difference between the groups regarding ROM, MEPS, OES and quick-DASH scores.

Conclusions

Within ten years following surgery, half of the patients with radial head prostheses were noted to show radiographic signs of loosening which did not have any major negative effect in terms of clinical-functional outcomes and quality of life, except requiring the removal of the implant in one patient.

Level of Evidence

Level III.

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References

  1. Bonnevialle N (2016) Radial head replacement in adults with recent fractures. Orthop Traumatol Surg Res 102(1):69–79

    Article  Google Scholar 

  2. Ferreira LM, Stacpoole RA, Johnson JA, King GJ (2010) Cementless fixation of radial head implants is affected by implant stem geometry: an in vitro study. Clin Biomech (Bristol, Avon) 25(5):422–426

    Article  Google Scholar 

  3. Mason ML (1954) Some observations on fractures of the head of the radius with a review of one hundred cases. T Br J Surg 42(172):123–132

    Article  CAS  Google Scholar 

  4. Shannon HL, Deluce SR, Giles JW, Johnson JA, King GJ (2015) The effect of radial head implant shape on radiocapitellar kinematics during in vitro forearm rotation. J Shoulder Elbow Surg 24(2):258–264

    Article  Google Scholar 

  5. Bryce CD, Armstrong AD (2008) Anatomy and biomechanics of the elbow. Orthop Clin North Am 39(2):141–154

    Article  Google Scholar 

  6. Morrey BF, Tanaka S, An KN (1991) Valgus stability of the elbow. A definition of primary and secondary constraints. Clin Orthop Relat Res 265:187–195

    Article  Google Scholar 

  7. Johnston GW (1962) A follow-up of one hundred cases of fracture of the head of the radius with a review of the literature. Ulster Med J 31:51–56

    CAS  PubMed  PubMed Central  Google Scholar 

  8. Ashwood N, Bain GI, Unni R (2004) Management of Mason type-III radial head fractures with a titanium prosthesis, ligament repair, and early mobilization. J Bone Joint Surg Am 87:136–147

  9. Grewal R, MacDermid JC, Faber KJ, Drosdowech DS, King GJ (2006) Comminuted radial head fractures treated with a modular metallic radial head arthroplasty. Study of outcomes. J Bone Joint Surg Am 88(10):2192–2200

  10. Cheung EV, Steinmann SP (2009) Surgical approaches to the elbow. T J Am Acad Orthop Surg 17(5):325–333

    Article  Google Scholar 

  11. Cusick MC, Bonnaig NS, Azar FM, Mauck BM, Smith RA, Throckmorton TW (2014) Accuracy and reliability of the Mayo Elbow Performance Score. J Hand Surg Am 39(6):1146–1150

    Article  Google Scholar 

  12. Yosmaoglu HB, Dogan D, Sonmezer E (2016) The reliability and validity of the Turkish version of the oxford elbow score. J J Orthop Surg Res 11(1):95

    Article  Google Scholar 

  13. Stepan JG, London DA, Boyer MI, Calfee RP (2013) Accuracy of patient recall of hand and elbow disability on the QuickDASH questionnaire over a two-year period. J Bone Joint Surg Am 95(22):e176

    Article  Google Scholar 

  14. Sun H, Duan J, Li F (2016) Comparison between radial head arthroplasty and open reduction and internal fixation in patients with radial head fractures (modified Mason type III and IV): a meta-analysis. Eur J Orthop Surg Traumatol 26(3):283–291

    Article  Google Scholar 

  15. Li N, Chen S (2014) Open reduction and internal-fixation versus radial head replacement in treatment of Mason type III radial head fractures. Eur J Orthop Surg Traumatol 24(6):851–855

    Article  Google Scholar 

  16. Morrey BF, Askew LJ, Chao EY (1981) A biomechanical study of normal functional elbow motion. J Bone Joint Surg Am 63(6):872–877

    Article  CAS  Google Scholar 

  17. Flinkkila T, Kaisto T, Sirnio K, Hyvonen P, Leppilahti J (2012) Short- to mid-term results of metallic press-fit radial head arthroplasty in unstable injuries of the elbow. J Bone Joint Surg Br 94(6):805–810

    Article  CAS  Google Scholar 

  18. Moro JK, Werier J, MacDermid JC, Patterson SD, King GJ (2001) Arthroplasty with a metal radial head for unreconstructible fractures of the radial head. J Bone Joint Surg Am 83(8):1201–1211

    Article  CAS  Google Scholar 

  19. Nosenzo A, Galavotti C, Menozzi M, Garzia A, Pogliacomi F, Calderazzi F (2021) Acute radial head replacement with bipolar prostheses: midterm results. Eur J Orthop Surg Traumatol 31(2):309–318

    Article  Google Scholar 

  20. Galavotti C, Padovani S, Nosenzo A, Menozzi M, Maniscalco P, Concari G, Villani C, Sabetta E et al (2021) RADIAL head arthroplasty: does ligaments repair influence outcomes? A minimum two years follow-up radiographic multi-center study. Eur J Orthop Surg Traumatol 24

  21. Gruen TA, McNeice GM, Amstutz HC (1979) “Modes of failure” of cemented stem-type femoral components: a radiographic analysis of loosening. Clin Orthop Relat Res 141:17–27

    Google Scholar 

  22. Shore BJ, Mozzon JB, MacDermid JC, Faber KJ, King GJ (2008) Chronic posttraumatic elbow disorders treated with metallic radial head arthroplasty. J Bone Joint Surg Am 90(2):271–280

    Article  Google Scholar 

  23. Popovic N, Lemaire R, Georis P, Gillet P (2007) Midterm results with a bipolar radial head prosthesis: radiographic evidence of loosening at the bone-cement interface. J Bone Joint Surg Am 89(11):2469–2476

    PubMed  Google Scholar 

  24. Delclaux S, Lebon J, Faraud A, Toulemonde J, Bonnevialle N, Coulet B et al (2015) Complications of radial head prostheses. Int Orthop 39(5):907–913

    Article  Google Scholar 

  25. Schmidt-Horlohe K, Buschbeck S, Wincheringer D, Weissenberger M, Hoffmann R (2016) Primary radial head arthroplasty in trauma : Complications. Orthopade 45(10):853–860

    CAS  PubMed  Google Scholar 

  26. Nolte PC, Tross AK, Groetzner-Schmidt C, Jung MK, Porschke F, Grützner PA, Guehring T, Schüler S, Schnetzke M (2021) Risk radial head factors for revision surgery following arthroplasty without cement for unreconstructible radial head fractures: minimum 3-Year follow-up. J Bone Joint Surg Am 103(8):688–695

    Article  Google Scholar 

  27. Chen AC, Weng CJ, Chiu CH, Chang SS, Cheng CY, Chan YS (2020) Retrospective cohort study on radial head arthroplasty comparing long-term outcomes between valgus type injury and fracture dislocation. BMC Musculoskelet Disord 21(1):763

    Article  Google Scholar 

  28. van Riet RP, Sanchez-Sotelo J, Morrey BF (2010) Failure of metal radial head replacement. J Bone Joint Surg Br 92(5):661–667

    Article  Google Scholar 

  29. Laumonerie P, Reina N, Kerezoudis P, Declaux S, Tibbo ME, Bonnevialle N et al. (2017) The minimum follow-up required for radial head arthroplasty: a meta-analysis. Bone Joint J 99-B(12):1561–1570.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery and Traumatology, Emsey Hospital, Istanbul, Turkey

    Tuna Pehlivanoglu

  2. Faculty of Health Sciences, Istanbul Yeni Yüzyıl University, Istanbul, Turkey

    Tuna Pehlivanoglu

  3. Department of Orthopaedic Surgery and Traumatology, Istanbul Faculty of Medicine, Istanbul University, Çapa Fatih Istanbul, 34093, Istanbul, Turkey

    Ali Erşen & Serkan Bayram

  4. Department of Orthopaedic Surgery and Traumatology, Faculty of Medicine, Acıbadem University, Istanbul, Turkey

    Ata Can Atalar

  5. Department of Orthopaedic Surgery and Traumatology, School of Medicine, Koç University, Istanbul, Turkey

    Mehmet Demirhan

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  1. Tuna Pehlivanoglu
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  2. Ali Erşen
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Correspondence to Serkan Bayram.

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The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Ethical approval

This study received institutional review board approval of Istanbul University, Istanbul Faculty of Medicine, Department of Orthopedic Surgery and Traumatology with the registry number of 1210037.

Informed consent

The procedures were explained in detail and written informed consent was obtained from all patients.

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Pehlivanoglu, T., Erşen, A., Bayram, S. et al. Cemented radial head arthroplasty: Does radiographic loosening have an effect on clinical and functional outcomes? Average 10 years’ results. Eur J Orthop Surg Traumatol 32, 1517–1524 (2022). https://doi.org/10.1007/s00590-021-03129-3

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  • DOI: https://doi.org/10.1007/s00590-021-03129-3

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