Acute radial head replacement with bipolar prostheses: midterm results

Area of Science:

• Orthopedic Surgery
• Biomaterials Science
• Radiology

Background:

• Radial head fractures, particularly those involving elbow stabilizers, necessitate prosthetic replacement to prevent instability and stiffness.
• Bipolar press-fit prostheses are used, but concerns exist regarding osteolysis and instability compared to monopolar implants.

Purpose of the Study:

• To evaluate midterm clinical and radiological outcomes of bipolar radial head implants.
• To assess the influence of osteolysis on proximal pain in patients with these implants.

Main Methods:

• Seventeen patients with irreparable radial head fractures received bipolar press-fit prostheses (rHEAD recon SBI/Stryker).
• Clinical outcomes were assessed using the Mỹel Elbow Performance Score (MEPS) and Disabilities of the Arm, Shoulder, and Hand (DASH) scores.
• Radiographic studies identified heterotopic ossifications and periprosthetic osteolysis.

Main Results:

• Excellent or good MEPS scores were achieved in 15 out of 17 patients, with no severe pain or instability reported.
• Osteolysis was detected in 9 cases, but showed no statistical correlation with MEPS scores or proximal pain.
• Three implants were removed due to early aseptic loosening.

Conclusions:

• Bipolar radial head implants provide reliable stability and good clinical outcomes when combined with accurate ligament repair.
• While osteolysis is common, it does not appear to significantly affect midterm clinical results or pain.
• The risk of early aseptic loosening with uncemented implants necessitates vigilant patient monitoring.