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Does radial head implant fixation affect functional outcomes? A systematic review and meta-analysis
Kofi D Agyeman1, Dhanur Damodar1, Ian Watkins2
1Department of Orthopaedic Surgery and Rehabilitation, University of Miami Hospital, Miami, FL, USA; Department of Orthopaedic Surgery and Rehabilitation, Jackson Memorial Hospital, Miami, FL, USA.
Journal of Shoulder and Elbow Surgery
|October 22, 2018
Summary
Implant fixation type does not significantly impact functional outcomes in radial head arthroplasty. However, rigidly fixed implants are associated with higher risks of revision and complications, suggesting a need for careful consideration in surgical planning.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
- Reconstructive Surgery
Background:
- Radial head arthroplasty treats nonreconstructible radial head fractures.
- Modern implants feature press-fit or cemented fixation for rigid congruity.
- Traditional implants offered looser fixation, acting primarily as spacers.
Purpose of the Study:
- To compare functional outcomes between fixed and unfixed radial head arthroplasty implants.
- To evaluate the impact of implant fixation methods on patient results.
Main Methods:
- Systematic review and meta-analysis of 36 articles.
- Inclusion of 878 patients (522 fixed, 356 unfixed).
- Qualitative and quantitative review of patient data and outcomes.
Main Results:
- No significant difference in Mayo Elbow Performance Scores, DASH scores, or range of motion between fixed and unfixed groups.
- Higher revision rates (7.9% vs. 3.1%) and complication rates (25.5% vs. 13.2%) in the fixed cohort.
- Fixed implants showed a 2.48-fold increased risk of revision and 1.88-fold increased risk of complications.
Conclusions:
- Implant fixation method (fixed vs. unfixed) does not appear to influence functional outcomes.
- Rigid fixation in radial head arthroplasty may elevate the risk of complications and the need for revision surgery.
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