Skip to main content
SpringerLink
Log in

Monobloc radial head prostheses in complex elbow injuries: results after primary and secondary implantation

  • Original Paper
  • Published:
International Orthopaedics Aims and scope Submit manuscript

Abstract

Purpose

Dislocations of components, loosening of the stem, overstuffing and removal in up to 24 % of common radial head prostheses (RHP) after implantation in complex elbow injuries signal the need for improvement. The latest biomechanical evidence shows advantages for monopolar designs. Clinical results after primary and secondary implantation of the newly designed press-fit monobloc monopolar RHP in cases of complex elbow injury are evaluated.

Methods

Twenty-nine patients [median age 60 years (29–86)] were followed up retrospectively for a median of 25 months (7–54) post-operatively. Subjective parameters, the Mayo Elbow Performance Score (MEPS), the Broberg and Morrey score (BMS), latest radiographs and complications were evaluated.

Results

MEPS and BMS averaged 87.2 ± 12.9 and 81.1 ± 11.9 points, respectively. No case of implant loosening was observed; the RHP had to be removed in one case (3 %). The overall complication and revision rate was higher after secondary (53 %) than after primary (19 %) implantation.

Conclusions

Satisfactory clinical results and low short-term removal rates emphasise the practicality of monobloc monopolar RHP. Differentiated treatment of complex elbow fracture-dislocations is compulsory to avoid the need for secondary RHP implantation which carries a higher complication rate.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Antuña SA, Sánchez-Márquez JM, Barco R (2010) Long-term results of radial head resection following isolated radial head fractures in patients younger than forty years old. J Bone Joint Surg Am 92:558–566

    Article  PubMed  Google Scholar 

  2. Broberg MA, Morrey BF (1986) Results of delayed excision of the radial head after fracture. J Bone Joint Surg Am 68:669–674

    PubMed  CAS  Google Scholar 

  3. Burkhart KJ, Mattyasovszky SG, Runkel M, Schwarz C, Küchle R, Hessmann MH, Rommens PM, Lars MP (2010) Mid- to long-term results after bipolar radial head arthroplasty. J Shoulder Elbow Surg 19:965–972

    Article  PubMed  Google Scholar 

  4. Burkhart KJ, Mattyasvszky SG, Runkel M, Schwarz C, Rump A, Kuechle R, Hessmann MH, Rommens PM, Müller LP (2011) Clinical and radiological results after Judet’s bipolar radial head prosthesis: long term effects. Ob Ex 6(2):108–114

    Google Scholar 

  5. Chanlalit C, Fitzsimmons JS, Moon JG, Berglund LJ, An KN, O’Driscoll SW (2011) Radial head prosthesis micromotion characteristics: partial versus fully grit-blasted stems. J Shoulder Elbow Surg 20:27–32

    Article  PubMed  Google Scholar 

  6. Chanlalit C, Shukla DR, Fitzsimmons JS, Thoreson AR, An KN, O’Driscoll SW (2011) Radiocapitellar stability: the effect of soft tissue integrity on bipolar versus monopolar radial head prostheses. J Shoulder Elbow Surg 20:219–225

    Article  PubMed  Google Scholar 

  7. Charalambous CP, Stanley JK, Mills SP, Hayton MJ, Hearnden A, Trail I, Gagey O (2011) Comminuted radial head fractures: aspects of current management. J Shoulder Elbow Surg 20:996–1007

    Article  PubMed  Google Scholar 

  8. Flinkkilä T, Kaisto T, Sirinö K, Hyvönen 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-B(6):805–810

    Article  Google Scholar 

  9. Frank SG, Grewal R, Johnson J, Faber KJ, King GJW, Athwal GS (2009) Determination of correct implant size in radial head arthroplasty to avoid overlengthening. J Bone Joint Surg Am 91:1738–1746

    Article  PubMed  Google Scholar 

  10. Harrington IJ, Sekyi-Otu A, Barrington TW, Evans DC, Tuli V (2001) The functional outcome with metallic radial head implants in the treatment of unstable elbow fractures: a long-term review. J Trauma 50(1):46–52

    Article  PubMed  CAS  Google Scholar 

  11. Ilahi OA, Bennett JB, Gabel GT, Mehlhoff TL, Kohl HW 3rd (2001) Classification of heterotopic ossification about the elbow. Orthopedics 24(11):1075–1078

    PubMed  CAS  Google Scholar 

  12. Kiene J, Wäldchen J, Schulz AP, Jürgens C, Paech A (2012) Midterm results of 19 fractures of the coronoid process of the ulna and concomitant injuries. Ob Ex 7(3):166–173

    Google Scholar 

  13. Moghaddam A, Lennert A, Studier-Fischer S, Wentzensen A, Zimmermann G (2008) Prosthesis after comminuted radial head fractures: midterm results. Unfallchirurg 111:997–1004

    Article  PubMed  CAS  Google Scholar 

  14. Moon JG, Berglund LJ, Zachary D, An KN, O’Driscoll SW (2009) Radiocapitellar joint stability with bipolar versus monopolar radial head prostheses. J Shoulder Elbow Surg 18:779–784

    Article  PubMed  Google Scholar 

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

    PubMed  Google Scholar 

  16. O’Driscoll SW, Herald JA (2012) Forearm pain associated with loose radial head prostheses. J Shoulder Elbow Surg 21:92–97

    Article  PubMed  Google Scholar 

  17. Ruan HJ, Fan CY, Liu JJ, Zeng BF (2009) A comparative study of internal fixation and prosthesis replacement for radial head fractures of Mason type II. Int Orthop 33:249–253

    Article  PubMed  Google Scholar 

  18. Sarris IK, Kyrkos MJ, Galanis NN, Papavasiliou KA, Sayegh FE, Kapetanos GA (2012) Radial head replacement with the MoPyC pyrocarbon prosthesis. J Shoulder Elbow Surg 21(9):1222–1228

    Article  PubMed  Google Scholar 

  19. Schofer MD, Peterlein CD, Kortmann HR (2008) Radial head prosthesis – treatment of comminuted radial head fractures combined with elbow instability. Z Orthop Unfall 146:760–767

    Article  PubMed  CAS  Google Scholar 

  20. Schneeberger AG, Sadowski MM, Jacob HAC (2004) Coronoid process and radial head as posterolateral rotator stabilizers of the elbow. J Bone Joint Surg Am 86:975–982

    PubMed  Google Scholar 

  21. Shukla DR, Fitzsimmons JS, An KN, O’Driscoll SW (2012) Effect of stem length on prosthetic radial head micromotion. J Shoulder Elbow Surg 21(11):1559–1564

    Article  PubMed  Google Scholar 

  22. Turner RG, Rispoli D, Lopez-Gonzalez FM, O’Driscoll SW (2012) Partial allograft replacement of the radial head in the management of complex fracture-dislocations of the elbow. J Shoulder Elbow Surg 21:396–404

    Article  PubMed  Google Scholar 

  23. van Riet RP, Morrey BF (2008) Documentation of associated injuries occurring with radial head fractures. Clin Orthop Relat Res 466:130–134

    Article  PubMed  Google Scholar 

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

    Article  Google Scholar 

  25. Zunkiewicz MR, Clemente JS, Miller MC, Baratz ME, Wysocki RW, Cohen MS (2012) Radial head replacement with a bipolar system: a minimum 2-year follow-up. J Shoulder Elbow Surg 21:98–104

    Article  PubMed  Google Scholar 

Download references

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Klinik für Unfall- und Wiederherstellungschirurgie, Diakoniekrankenhaus Friederikenstift gGmbH, Hanover, Germany

    Jan Christoph Katthagen, Gunnar Jensen, Helmut Lill & Christine Voigt

Authors
  1. Jan Christoph Katthagen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Gunnar Jensen
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Helmut Lill
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Christine Voigt
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jan Christoph Katthagen.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Katthagen, J.C., Jensen, G., Lill, H. et al. Monobloc radial head prostheses in complex elbow injuries: results after primary and secondary implantation. International Orthopaedics (SICOT) 37, 631–639 (2013). https://doi.org/10.1007/s00264-012-1747-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00264-012-1747-7

Keywords

Search

Navigation