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Radial Head Arthroplasty: A Systematic Review.
Andras Heijink1, Izaäk F Kodde1, Paul G H Mulder2
1Department of Orthopaedic Surgery, Academic Medical Center, Amsterdam, the Netherlands.
JBJS Reviews
|October 30, 2016
Summary
Current evidence does not favor any specific radial head prosthesis design over others for elbow arthroplasty outcomes. Silicone prostheses are the only exception, showing insufficient biological and biomechanical performance.
Area of Science:
- Orthopedic surgery
- Biomedical engineering
- Reconstructive surgery
Background:
- Radial head arthroplasty literature is expanding, with advancements in understanding elbow anatomy, biomechanics, and surgical techniques.
- Despite these advances, no definitive evidence supports one radial head prosthesis design over another.
Purpose of the Study:
- To review existing literature on radial head arthroplasty.
- To explore associations between prosthesis design, surgical timing, and patient outcomes.
Main Methods:
- A comprehensive literature search was conducted from January 1940 to May 2015.
- Studies included skeletally mature patients and focused on functional, subjective, and radiographic outcomes.
Main Results:
- Thirty articles involving 727 patients were analyzed, with implants made of cobalt-chromium, pyrocarbon, titanium, and Vitallium.
- Revision rates and postoperative range of motion were not significantly affected by prosthesis material, polarity, or fixation.
- Excellent or good results were achieved in 85% of patients with reported Mayo Elbow Performance Scores; 23% experienced complications.
Conclusions:
- No current evidence supports one radial head prosthesis type over another, except for silicone prostheses, which are biologically and biomechanically insufficient.
- Further research may be needed to establish optimal prosthesis selection criteria.
