Radial head arthroplasty with an uncemented modular metallic radial head prosthesis: short- and mid-term results.

BACKGROUND: In comminuted radial head fractures, arthroplasty is an alternative treatment to open reduction and internal fixation or radial head excision. The purpose of this study was to evaluate the short- and mid-term results after the implantation of the EVOLVE™ uncemented modular metallic radial head prosthesis.
METHODS: Twenty-five patients with an unreconstructible comminuted radial head fracture were treated with the EVOLVE™ prosthesis. Two groups were formed in order to evaluate short-term (mean 1.6 years, range 1-2.3 years) and mid-term (mean 5.1 years, range 3-7.2 years) results. The short-term group consisted of 10 patients and the mid-term group of 15 patients. Objective physical outcome (ROM, grip strength) and outcome scores (Broberg/Morrey score, DASH) as well as radiological findings (periprosthetic lucency, prosthetic sizing, heterotopic ossification, posttraumatic osteoarthritis) were evaluated.
RESULTS: Significant impairments in ROM and grip strength were observed in the affected arm. Differences in impairment of the affected arm between the two groups were not significant. There were no significant differences in the outcome scores between the two groups, with good results obtained overall. Understuffing was observed in 3 patients. Three patients had severe and 5 had no periprosthetic lucency. The groups barely differed in periprosthetic lucency.
CONCLUSIONS: Radial head arthroplasty with the EVOLVE™ prosthesis gave good results in terms of objective physical outcome and outcome scores at short- and mid-term follow-up. Periprosthetic lucency does not affect the outcome negatively. We assume that periprosthetic lucency does not necessarily imply prosthesis loosening in which revision is required. Radiological findings and the severity of the initial injury do not necessarily correlate with results.