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Implant Survivorship, Radiographic Evaluation, and Clinical Outcomes of Radial Head Arthroplasty Using The Depuy
Kate A Spitzley1, Kenneth P Butters2, Julie M Embree2
1Slocum Research and Education Foundation, Eugene, Oregon, USA.
Background:
Radial head arthroplasty (RHA) implants are designed either to promote osseo-integration with an anatomic stem or function as a loose-fitting spacer. Anatomic implants have shown painful loosening leading to revision or removal, making the loose-fitting design an appealing alternative. This study evaluates short-term survivorship and clinical, radiographic, and patient reported outcomes following RHA using the DePuy Synthes monoblock loose fit radial head replacement system.
Methods:
Nineteen patients (mean age 54 SD 17 years), who underwent RHA were enrolled, with a mean follow-up of 14.9 SD 6.8 months. Fractures were classified using Mason and Regan-Morrey systems. Fifteen patients returned for in-person evaluation with x-rays, physician and physical therapist examination and patient reported outcome (PRO) questionnaires. Four remote participants completed PROs only.
Results:
The cohort consisted of 8 females and 11 males, with 10 patients sustaining associated elbow dislocations and 13 with concurrent coronoid fractures. No patient had the implant removed or revised. PROs indicated excellent functional outcomes: Mayo Elbow Performance Score of 90 SD 12, QuickDash of 13 SD 9 (minor disability) and EQ-5D of 0.77 SD 0.18 (mild disability). Grip strength in the operative limb was 90% SD 14% of the non-operative and range of motion was greater than 90% of the non-operative side. Heterotopic bone formation was noted in 7 patients but did not limit motion. Mild periprosthetic radiolucency around the stem was noted in 14 patients. Moderate capitellar erosion was noted in one patient with an Essex-Lopresti injury.
Conclusion:
The DePuy Synthes radial head replacement system demonstrated excellent shortterm outcomes in terms of survivorship, functional recovery and patient satisfaction. Although mild radiographic lucencies and heterotopic ossification were observed, they did not impact functional outcome. These findings support the safety and efficacy of this implant, though longer-term follow-up is necessary to assess its durability and performance.
Level Of Evidence:
IV.
