Radial Neck Dilatory Remodeling After Radial Head Arthroplasty With an Uncemented, Press Fit, Fully Chemically Etched Stem Design

J Orthop Trauma. 2017 Sep;31(9):497-502. doi: 10.1097/BOT.0000000000000876.

Abstract

Objectives: To compare the radiographic outcomes of 2 widely used side loading, press fit, RHA implants used to reconstruct complex elbow trauma.

Design: Retrospective cohort study.

Setting: Level-1 Academic trauma center.

Participants: Patients undergoing RHA.

Intervention: Cohort 1 received Synthes Radial Head Prosthesis. Cohort 2 received Biomet ExploR Radial Head Replacement.

Main outcome measurements: Radial neck dilatory remodeling.

Results: Eighty-two subjects were included in final analysis, 63 from the Biomet Cohort, and 19 from Synthes cohort. Demographic and injury characteristics were similar among cohorts. Radial neck dilatory remodeling as well as periprosthetic radiographic lucency were seen significantly more frequently and to a significantly greater degree in the Synthes cohort. The average percentage of dilatory remodeling of the Synthes cohort was 34.9% and that of the Biomet cohort was 2.7%. There were no differences in rates of revision surgery.

Conclusions: Our study demonstrates significant radiographic differences between 2 frequently used RHA implants. Radial neck dilatory remodeling is a common, rapidly progressive, and dramatic finding frequently seen with the Synthes Radial Head Prosthesis.

Level of evidence: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

MeSH terms

  • Academic Medical Centers
  • Adult
  • Aged
  • Arthroplasty, Replacement, Elbow / adverse effects
  • Arthroplasty, Replacement, Elbow / methods*
  • Cohort Studies
  • Elbow Injuries
  • Elbow Joint / surgery*
  • Female
  • Follow-Up Studies
  • Fracture Healing / physiology
  • Humans
  • Intra-Articular Fractures / diagnostic imaging
  • Intra-Articular Fractures / surgery*
  • Male
  • Middle Aged
  • Prosthesis Design
  • Radius Fractures / diagnostic imaging
  • Radius Fractures / surgery*
  • Range of Motion, Articular / physiology
  • Recovery of Function
  • Reoperation / methods
  • Retrospective Studies
  • Risk Assessment
  • Trauma Centers
  • Treatment Outcome