Complications of radial head prostheses

Area of Science:

• Orthopedic surgery
• Biomaterials science

Background:

• Radial head prostheses treat complex radial head fractures unsuitable for fixation.
• Metallic or pyrocarbon implants have been used for two decades, replacing earlier silastic options.

Purpose of the Study:

• To review known complications associated with metallic and pyrocarbon radial head prostheses.
• To identify factors contributing to implant failure and patient morbidity.

Main Methods:

• Literature review of complications related to radial head arthroplasty.
• Analysis of proposed etiological factors for implant-related issues.

Main Results:

• Loosening (cemented and uncemented) is a primary complication, potentially due to stem design, cement technique, stress shielding, or foreign body reactions.
• Pain and stiffness often result from oversized components or joint overstuffing, leading to radius lengthening.
• Instability may occur in severe trauma with associated ligament and coronoid fractures, necessitating specific surgical interventions for joint stabilization.
• Osteoarthritis is a frequent long-term complication.

Conclusions:

• Complications of radial head prostheses are multifactorial, involving implant characteristics and surgical execution.
• Addressing factors like implant fit, cementation, and associated injuries is crucial for optimal outcomes.
• Further research into implant design and surgical techniques may mitigate long-term complications such as osteoarthritis.