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Tight-fitting radial head prosthesis: does stem size help prevent painful loosening?

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Abstract

Introduction

The most common reason for removal of well-fixed radial head prostheses is painful loosening. We hypothesised that short-stemmed prostheses, used for radial head arthroplasty, are not associated with an increased risk of implant loosening.

Methods

From 2002 to 2014, 65 patients were enrolled in a retrospective single-centre study. The radial head prostheses were classified as having either a long (30-mm) or short (16- to 22-mm) stem. The long-stemmed implants comprised 30 GUEPAR® DePuy Synthes (West Chester, PA, USA) and 20 Evolutive® Aston Medical (Saint-Etienne, France) devices; the short-stemmed implants comprised nine RECON and six STANDARD rHead® SBI-Stryker (Morrisville, PA, USA) devices. At last follow-up, clinical (range of motion, Disabilities of the Arm, Shoulder, and Hand score, Mayo Elbow Performance score) and radiographic (osteolysis) outcomes were assessed.

Results

At a mean follow-up of 76.78 months (24–141), the rate of painful loosening [6 (40%) vs 8 (16%), p = 0.047] and osteolysis [12 (80%) vs 23 (46%), p = 0.02] were significantly higher in patients with short-stemmed versus long-stemmed implants. Despite the significant difference in loosening between stems as groups, individual stem length was not determined.

Conclusions

Tight-fitting implants with short stems are more prone to painful loosening.

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Funding

All the authors (Pierre Laumonerie, Nicolas Reina, Claudia Gutierrez, Stephanie Delclaux, Meagan E Tibbo, Nicolas Bonnevialle, Pierre Mansat) and their immediate family, and any research foundation with which they are affiliated, did not receive any financial payments or other benefits from any commercial entity related to the subject of this article.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Hôpital Pierre-Paul Riquet, Place du Docteur Baylac, 31059, Toulouse, France

    Pierre Laumonerie, Nicolas Reina, Stephanie Delclaux, Nicolas Bonnevialle & Pierre Mansat

  2. Mayo Clinic School of Medicine, 200 1st St SW, Rochester, MN, 55905, USA

    Claudia Gutierrez

  3. Department of Orthopedic Surgery, Mayo Clinic, 200 1st St SW, Rochester, MN, 55905, USA

    Meagan E. Tibbo

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  1. Pierre Laumonerie
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Correspondence to Pierre Laumonerie.

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All the authors (Pierre Laumonerie, Nicolas Reina, Claudia Gutierrez, Stephanie Delclaux, Meagan E Tibbo, Nicolas Bonnevialle, Pierre Mansat) report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper.

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Laumonerie, P., Reina, N., Gutierrez, C. et al. Tight-fitting radial head prosthesis: does stem size help prevent painful loosening?. International Orthopaedics (SICOT) 42, 161–167 (2018). https://doi.org/10.1007/s00264-017-3644-6

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