C Galavotti1, S Padovani2, A Nosenzo3, M Menozzi3, P Maniscalco4, G Concari5, C Villani6, E Sabetta6, A Belluati7, M Monesi8, L Massari9, C Pari7, M Cavaciocchi2, F Calderazzi3, A Colozza2. 1. Ortopedia e Traumatologia POC, ASST Cremona, Viale Concordia 1, 26100, Cremona, Cremona, Italy. galavotticristina@gmail.com. 2. Ortopedia e Traumatologia Ospedale Degli Infermi Faenza, Viale Stradone, 9, 48018, Faenza, Ravenna, Italy. 3. Clinica Ortopedica, A.O.U. Parma, Via Gramsci, 14, 43126, Parma, Parma, Italy. 4. Ortopedia e Traumatologia AUSL Piacenza, Via Taverna Giuseppe 49, 29121, Piacenza, Piacenza, Italy. 5. UOC Ortopedia e Traumatologia, Ospedale di Vaio Fidenza, Via Don Enrico Tincati 5, 43036, Parma, Parma, Italy. 6. UOC Ortopedia e Traumatologia, Ospedale S. Maria Nuova Reggio Emilia, Viale Risorgimento 80, 42123, Reggio Emilia, Reggio Emilia, Italy. 7. Ortopedia e Traumatologia, Ospedale S. Maria Delle Croci, Viale Vincenzo Randi 5, 48121, Ravenna, Italy. 8. Ortopedia e Traumatologia, Ospedale M. Bufalini Cesena, Viale G. Ghirotti 286, 47521, Cesena, Forlì-Cesena, Italy. 9. Dipartimento Ortopedia e Traumatologia, A.O.U., Via Aldo Moro 7 Cona, 44124, Ferrara, Italy.
Abstract
PURPOSE: The current indication for comminuted radial head fractures is radial head arthroplasty (RHA). The main purpose of this study was to investigate any statistical differences in terms of prosthesis revision or removal and radiographic degenerative changes by comparing patients who underwent RHA and ligaments repair to those who underwent only RHA implant at minimum two years follow-up. The secondary aim was to delineate a trend profile of RHA implants. METHODS: All patients who underwent RHA surgery for traumatic pathology between January 2012 and December 2017 were eligible. Two researchers independently and retrospectively reviewed the patients' charts and collected the following data: type of prosthesis, associated surgical procedures and revision surgery. They also looked for any radiographic sign of prosthesis loosening, overstuffing, capitellar osteopenia, heterotopic ossification and degenerative changes. No clinical evaluation was performed. RESULTS: In 6 years, 124 RHA were implanted (74 female, 50 male, mean age 56). The main diagnoses were: terrible triad, trans-olecranon fracture and isolated radial head fracture. It was found no significant statistical difference between the 2 groups; nevertheless, the cohort of patients that underwent ligaments repair had a lower revision rate in comparison with the other. Suture of the annular ligament seems to be critical. The overall revision rate was 10.5%. CONCLUSION: This multi-center study found no evidence that ligaments repair, as an associated surgical procedure, improves RHA longevity, except for annular ligament. Nevertheless, it seems to prevent degenerative changes at midterm follow-up.
PURPOSE: The current indication for comminuted radial head fractures is radial head arthroplasty (RHA). The main purpose of this study was to investigate any statistical differences in terms of prosthesis revision or removal and radiographic degenerative changes by comparing patients who underwent RHA and ligaments repair to those who underwent only RHA implant at minimum two years follow-up. The secondary aim was to delineate a trend profile of RHA implants. METHODS: All patients who underwent RHA surgery for traumatic pathology between January 2012 and December 2017 were eligible. Two researchers independently and retrospectively reviewed the patients' charts and collected the following data: type of prosthesis, associated surgical procedures and revision surgery. They also looked for any radiographic sign of prosthesis loosening, overstuffing, capitellar osteopenia, heterotopic ossification and degenerative changes. No clinical evaluation was performed. RESULTS: In 6 years, 124 RHA were implanted (74 female, 50 male, mean age 56). The main diagnoses were: terrible triad, trans-olecranon fracture and isolated radial head fracture. It was found no significant statistical difference between the 2 groups; nevertheless, the cohort of patients that underwent ligaments repair had a lower revision rate in comparison with the other. Suture of the annular ligament seems to be critical. The overall revision rate was 10.5%. CONCLUSION: This multi-center study found no evidence that ligaments repair, as an associated surgical procedure, improves RHA longevity, except for annular ligament. Nevertheless, it seems to prevent degenerative changes at midterm follow-up.
Authors: Femke M A P Claessen; Rens Bexkens; I F Kodde; Job N Doornberg; Michel P J V D Bekerom; Denise Eygendaal Journal: Arch Bone Jt Surg Date: 2020-01