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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2018-06-01
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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 |
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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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1612690723381968896 |