Long-term outcomes of modular metal prosthesis replacement in patients with irreparable radial head fractures

Abstract Background The purposes of this study were to investigate the long-term outcomes of radial head replacement and to analyze the relationship between functional outcomes and periprosthetic radiolucency. Methods We retrospectively reviewed 32 patients who underwent unilateral radial head repla...

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Main Authors: Alvin Chao-Yu Chen, Ying-Chao Chou, Chun-Jui Weng, Chun-Ying Cheng
Format: Article
Language:English
Published: BioMed Central 2018-06-01
Series:Journal of Orthopaedic Surgery and Research
Subjects:
Online Access:http://link.springer.com/article/10.1186/s13018-018-0844-8
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spelling doaj-art-fa74f6a1a5a24222b6cbcbacd2ff4bd22018-08-20T08:34:32ZengBioMed CentralJournal of Orthopaedic Surgery and Research1749-799X2018-06-011311710.1186/s13018-018-0844-8Long-term outcomes of modular metal prosthesis replacement in patients with irreparable radial head fracturesAlvin Chao-Yu Chen0Ying-Chao ChouChun-Jui WengChun-Ying ChengBone and Joint Research Center, Department of Orthopaedic Surgery, Chang Gung Memorial Hospital–Linkou and Chang Gung University College of MedicineAbstract Background The purposes of this study were to investigate the long-term outcomes of radial head replacement and to analyze the relationship between functional outcomes and periprosthetic radiolucency. Methods We retrospectively reviewed 32 patients who underwent unilateral radial head replacement between 2004 and 2011. Data on patient characteristics including age, gender, injury complexity, associated trauma, injury chronicity, and number of surgeries were collected and analyzed. Of these patients, 14 had terrible triad injury, 14 valgus-type injuries, 3 Monteggia fracture, and 1 concomitant distal humerus fracture. Clinical survey was performed at 7 to 15 years after replacement surgery. The Mayo Elbow Performance Score (MEPS) and shortened Disabilities of the Arm, Shoulder, and Hand (quickDASH) score were used for functional evaluation. Residual elbow or forearm pain was evaluated using visual analog scale (VAS). Radiographs were reviewed by orthopedic and radiologic specialists, and periprosthetic radiolucency was measured based on the diameter of radial head prosthesis. Results The 32 patients returned for follow-up at an average of 8.94 years. None underwent prosthesis revision or removal. MEPS averaged 83.4; good or excellent results were achieved in 26 patients. QuickDASH scores averaged 11.7. Significantly better MEPS (p = 0.023) and quickDASH scores (p = 0.026) were noted when replacement surgery served as the primary surgery instead of late salvage. VAS scores averaged 1.25, with residual pain noted in 24 elbows (75%). Periprosthetic radiolucency was noted in 21 patients (66%) with a mean thickness of 3.53 mm. The difference in functional outcomes was not significant between patients with and without radiolucency, with p values of 0.127 for MEPS and 0.135 for quickDASH scores. Spearman correlation analysis showed low correlation between the measured width of radiolucency and VAS scores (r = 0.143). Conclusion Sustained, encouraging clinical outcomes were reported in the present study. Although periprosthetic radiolucency did not correlate with functional or pain scores, surgical optimization and meticulous survey were warranted.http://link.springer.com/article/10.1186/s13018-018-0844-8Radial head fractureRadial head replacementProsthesisRadiolucency
institution Open Data Bank
collection Open Access Journals
building Directory of Open Access Journals
language English
format Article
author Alvin Chao-Yu Chen
Ying-Chao Chou
Chun-Jui Weng
Chun-Ying Cheng
spellingShingle Alvin Chao-Yu Chen
Ying-Chao Chou
Chun-Jui Weng
Chun-Ying Cheng
Long-term outcomes of modular metal prosthesis replacement in patients with irreparable radial head fractures
Journal of Orthopaedic Surgery and Research
Radial head fracture
Radial head replacement
Prosthesis
Radiolucency
author_facet Alvin Chao-Yu Chen
Ying-Chao Chou
Chun-Jui Weng
Chun-Ying Cheng
author_sort Alvin Chao-Yu Chen
title Long-term outcomes of modular metal prosthesis replacement in patients with irreparable radial head fractures
title_short Long-term outcomes of modular metal prosthesis replacement in patients with irreparable radial head fractures
title_full Long-term outcomes of modular metal prosthesis replacement in patients with irreparable radial head fractures
title_fullStr Long-term outcomes of modular metal prosthesis replacement in patients with irreparable radial head fractures
title_full_unstemmed Long-term outcomes of modular metal prosthesis replacement in patients with irreparable radial head fractures
title_sort long-term outcomes of modular metal prosthesis replacement in patients with irreparable radial head fractures
publisher BioMed Central
series Journal of Orthopaedic Surgery and Research
issn 1749-799X
publishDate 2018-06-01
description Abstract Background The purposes of this study were to investigate the long-term outcomes of radial head replacement and to analyze the relationship between functional outcomes and periprosthetic radiolucency. Methods We retrospectively reviewed 32 patients who underwent unilateral radial head replacement between 2004 and 2011. Data on patient characteristics including age, gender, injury complexity, associated trauma, injury chronicity, and number of surgeries were collected and analyzed. Of these patients, 14 had terrible triad injury, 14 valgus-type injuries, 3 Monteggia fracture, and 1 concomitant distal humerus fracture. Clinical survey was performed at 7 to 15 years after replacement surgery. The Mayo Elbow Performance Score (MEPS) and shortened Disabilities of the Arm, Shoulder, and Hand (quickDASH) score were used for functional evaluation. Residual elbow or forearm pain was evaluated using visual analog scale (VAS). Radiographs were reviewed by orthopedic and radiologic specialists, and periprosthetic radiolucency was measured based on the diameter of radial head prosthesis. Results The 32 patients returned for follow-up at an average of 8.94 years. None underwent prosthesis revision or removal. MEPS averaged 83.4; good or excellent results were achieved in 26 patients. QuickDASH scores averaged 11.7. Significantly better MEPS (p = 0.023) and quickDASH scores (p = 0.026) were noted when replacement surgery served as the primary surgery instead of late salvage. VAS scores averaged 1.25, with residual pain noted in 24 elbows (75%). Periprosthetic radiolucency was noted in 21 patients (66%) with a mean thickness of 3.53 mm. The difference in functional outcomes was not significant between patients with and without radiolucency, with p values of 0.127 for MEPS and 0.135 for quickDASH scores. Spearman correlation analysis showed low correlation between the measured width of radiolucency and VAS scores (r = 0.143). Conclusion Sustained, encouraging clinical outcomes were reported in the present study. Although periprosthetic radiolucency did not correlate with functional or pain scores, surgical optimization and meticulous survey were warranted.
topic Radial head fracture
Radial head replacement
Prosthesis
Radiolucency
url http://link.springer.com/article/10.1186/s13018-018-0844-8
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