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Failure of metal radial head replacement
R P van Riet1, J Sanchez-Sotelo, B F Morrey
1Monica Hospital SPM Deurne, Stevenslei 20, 2100 Deurne, Belgium.
Summary
Metallic radial head implants often fail due to loosening and degenerative changes. Revision surgery is frequently needed for these complications, particularly in cases of painful loosening and stiffness.
Area of Science:
- Orthopedic Surgery
- Biomaterials Science
- Medical Device Engineering
Background:
- Modern metallic radial head implants are widely used for elbow fractures.
- Information on the failure mechanisms of these implants is limited.
- Understanding failure modes is crucial for improving implant design and patient outcomes.
Purpose of the Study:
- To investigate the mechanisms of failure in modern metallic radial head implants.
- To identify common indications for revision surgery after radial head replacement.
- To analyze factors associated with implant failure.
Main Methods:
- Retrospective review of 44 patients (47 elbows) who underwent removal of failed metallic radial head replacements between 1998 and 2008.
- Analysis of indications for revision surgery, including loosening, stiffness, instability, and infection.
- Assessment for radiographic signs of implant failure, such as over-lengthening and degenerative changes.
Main Results:
- The most common indication for revision was painful loosening (31 elbows).
- Other indications included stiffness (18 elbows), instability (9 elbows), and deep infection (2 elbows).
- Signs of radial over-lengthening were observed in 11 elbows, and degenerative changes were present in nearly all cases.
Conclusions:
- Painful loosening and degenerative changes are primary failure modes of metallic radial head implants.
- Revision surgery is frequently required for complications associated with these implants.
- Bipolar implants showed no signs of instability, suggesting potential benefits in certain cases.
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