Complications after radial head arthroplasty: a comparison between short-stemmed bipolar and monopolar long-stemmed osteointegrative rigidly fixed prostheses
| Autor: | Yves Gramlich, Eva-Lorine Krausch, Alexander Klug, Kay Schmidt-Horlohé, Johannes Buckup, Reinhard Hoffmann |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male Reoperation medicine.medical_specialty medicine.medical_treatment Elbow Prosthesis Prosthesis Design Prosthesis Young Adult 03 medical and health sciences 0302 clinical medicine Radial head arthroplasty Elbow Joint Humans Medicine Orthopedics and Sports Medicine Revision rate Device Removal Aged 030203 arthritis & rheumatology 030222 orthopedics Bone-Anchored Prosthesis business.industry Arthroplasty Replacement Elbow Mean age Middle Aged Prosthesis Failure Surgery Equipment Failure Analysis Concomitant Radiological weapon Orthopedic surgery Female Radial head fracture Radius Fractures Elbow Injuries business |
| Zdroj: | International Orthopaedics. 43:1917-1925 |
| ISSN: | 1432-5195 0341-2695 |
| DOI: | 10.1007/s00264-018-4173-7 |
| Popis: | To date, only a few studies have compared radial head prostheses (RHP) and their different anchoring principles. The aim of this study was to characterize concomitant injuries, necessary adjuvant procedures, complications, and radiological findings after implantation of two different types of RHP. Sixty-six patients with radial head fractures were treated with MoPyC (Tornier/France, 50 mm stem, monopolar) or SBI rHead prostheses (Small Bone Innovations/USA, 22-mm stem, bipolar) and followed up over 42 months (16–64 months). Primary objective was the detection of different loosening and explantation rates. In addition to the revision rate and the reasons for revision, we also used radiological findings to assess the dynamics of lysis phenomena. Thirty-five patients (mean age 48 years; 22–73 years) were treated with the MoPyC, and 31 patients (mean age 47 years, 19–69 years) with the rHead prosthesis. Of these, 98% had a Mason 3 or 4 type of radial head fracture, and 94% showed concomitant injuries, which were addressed in 89% of cases by adjuvant procedures. The surgical revision rate was 20% (rHead 23%; MoPyC 18%). Significantly more of the rHead prostheses had to be explanted compared to MoPyC prostheses because of painful loosening (16% vs. 3%; p = 0.029). Predictors of subsequent loosening were significant radiolucent lines in the RHP over the first six months and an increase in width by two and a half times within the first 50 days after implantation. Complex radial head fractures are frequent and difficult to treat. The monopolar long-stemmed prosthesis showed significantly lower rates of painful loosening and explanation rates than the bipolar short-stemmed prosthesis. |
| Databáze: | OpenAIRE |
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