Press-fit bipolar radial head arthroplasty, midterm results

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• 作者：Izaä ; k F. Kodde ; MD^a ; ^b ; ^{if.kodde@hotmail.com" class="auth_mail" title="E-mail the corresponding author} ; Andras Heijink ; MD^a ; ^b ; Laurens Kaas ; MD ; PhD^a ; Paul G.H. Mulder ; PhD^c ; C. Niek van Dijk ; MD ; PhD^b ; Denise Eygendaal ; MD ; PhD^a
• 关键词：Level IV ; Case Series ; Treatment Study
• 刊名：Journal of Shoulder and Elbow Surgery
• 出版年：2016
• 出版时间：August 2016
• 年：2016
• 卷：25
• 期：8
• 页码：1235-1242
• 全文大小：818 K

文摘

Theoretical advantages of bipolar compared with monopolar radial head arthroplasty include better accommodation of radiocapitellar malalignment, reduction of capitellar abrasion, and reduction of stress at the bone-implant interfaces. Our purpose was to report the midterm results of press-fit bipolar radial head arthroplasty.

c_2">Methods

Thirty patients were treated by press-fit bipolar radial head arthroplasty for acute fracture of the radial head, failed earlier treatment, or post-traumatic sequelae. Three patients were lost to follow-up. Results are presented for the remaining 27 patients.

c_3">Results

At mean follow-up of 48 months (range, 28-73), there had been 3 (11%) revisions. Two involved conversion to prosthetic radiocapitellar hemiarthroplasty for symptomatic capitellar abrasion; a third involved exchange of the articular component (ie, head) for instability. In all, the stems appeared well fixed. A prosthesis in a subluxed position accounted for the 1 (4%) additional radiologic failure. The average flexion-extension arc was 136° (range, 120°-145°), and the average pronation-supination arc was 138° (range, 70°-180°). According to the Mayo Elbow Performance Score, the combined excellent and good results accounted for 70%.

c_4">Conclusions

The overall midterm outcome of this series of 30 press-fit bipolar radial head arthroplasties can be considered favorable. Although the revision rate was 11%, the stems were well fixed in all. There was 1 (4%) additional radiologic failure. We suggest considering a press-fit bipolar radial head prosthesis for acute comminuted radial head fractures with limited bone loss of the proximal radius.