Radiographic Predictors for Short-term Functional Outcome after Radial Head Arthroplasty in Patients with Persistent Symptoms after Treatment for Radial Head

Authors

  • Bexkens, Rens Orthotrauma Research Center Amsterdam, University of Amsterdam, Amsterdam, the Netherlands; Department of Orthopaedic Surgery, Hand and Upper Extremity Service, Massachusetts General Hospital, Boston, MA, USA
  • Denise Eygendaal Orthopaedic Surgeon, Department of Orthopaedic Surgery, Upper Limb Unit, Amphia Hospital, Breda, the Netherlands
  • Femke M.A.P. claessen Orthotrauma Research Center Amsterdam, University of Amsterdam, Amsterdam, the Netherlands; Department of Orthopaedic Surgery, Hand and Upper Extremity Service, Massachusetts General Hospital, Boston, MA, USA
  • I. F. Kodde Department of Orthopaedic Surgery, Academic Medical Center, Amsterdam, the Netherlands; Department of Orthopaedic Surgery, Upper Limb Unit, Amphia Hospital, Breda, the Netherlands
  • Job N. Doornberg Academic Medical Center, Amsterdam, the Netherlands, Department of Orthopaedic Surgery, Upper Limb Unit, Amphia Hospital, Breda, the Netherlands
  • Michel P. J. V. Bekerom Department of Orthopaedic Surgery, Shoulder and Elbow Unit, Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands
Abstract:

Background: Evaluation of the accurate position after radial head arthroplasty remains a challenge for surgeons.Standard radiographs are used to evaluate the position of the implant, however, results regarding radiographicdeficiencies on clinical outcome are not consistent. In this retrospective study our main aim was to determine if subtleradiographic deficiencies after radial head arthroplasty can predict functional outcomes measured with the Mayo ElbowPerformance Score (MEPS).Methods: A total of 24 patients, that had a press-fit bipolar radial head arthroplasty because of persistent symptomsafter treatment of a radial head fracture, were included. The mean follow-up time was 27 months and the MEPS wasassessed at the final follow-up. Three upper extremity orthopaedic surgeons evaluated 12 potential deficiencies onanteroposterior and lateral radiographs in consensus agreement.Results: The median MEPS was 97.5 (Interquartile Range 82.5-100). No association was found between the presenceof subtle radiographic deficiencies and MEPS.Conclusion: Functional outcome of the elbow after uncemented press-fit bipolar radial head arthroplasty is notassociated with subtle radiographic deficiencies. Therefore, surgeons might accept small imperfections on postoperativeradiographs.Level of evidence: IV

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Journal title

volume 8  issue 1

pages  27- 32

publication date 2020-01-01

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