Romain Ceccarelli1, Matthias Winter2, Hugo Barret3, Nicolas Bronsard3, Marc Olivier Gauci3. 1. Polyclinique Saint Jean, 92-94 Avenue Dr Maurice Donat, 06800 Cagnes-sur-Mer, France. Electronic address: dr.ceccarelliromain@gmail.com. 2. Polyclinique Saint Jean, 92-94 Avenue Dr Maurice Donat, 06800 Cagnes-sur-Mer, France. 3. Centre Hospitalier Universitaire de Nice, Pasteur 2, 30 Voie Romaine, 06000 Nice, France.
Abstract
BACKGROUND: Several studies have already reported good short-term results in pyrocarbon unipolar radial head prosthesis (Pyc-uRHP). The aim was to evaluate the evolution from mid-term to long-term clinical and radiographic outcomes of a Pyc-uRHP. METHODS: It was a retrospective, monocentric study. We followed all the patients who undergone Pyc-uRHP surgery from our original study at 2 years of follow-up (52 patients) to reach a minimum of 7 years of clinical and radiological follow-up. 26 patients were included at a mean follow-up of 110 months (78-162 months)) for a clinical examination with mobility, Mayo Elbow Performance Score (MEPS), VAS and radiological evaluation with A/P and profile X-rays. The radiological study analyzed signs of proximal osteolysis, stem loosening, capitellar wear and humero-ulnar osteoarthritis. RESULTS: No patients required revision. Eight patients required reoperation: 1 coronoid screw removal and 7 arthrolysis for stiffness. The mean time to reoperation was 11 months. The mean MEPS at last follow-up was 96±9/100, with pain 42±7/45, mobility 19±2/20, stability 10/10 and function 25/25. Comparison with clinical data from the mid-term delay did not reveal any significant difference. All patients presented a proximal osteolysis around the neck but without progression. No stem loosening was noticed. Humeroulnar osteoarthritis (12% at mid-term vs 80% at last follow-up, p<0.0001) and capitellar lesions (34% at mid-term vs 80% at last follow-up, p=0.001) increased significantly. CONCLUSION: We have shown that a Pyc-uRHP at 9 years follow-up provided stable and satisfactory clinical results. Osteolysis of the radial neck is always present, but it did not evolve, and no stem loosening was noticed. Finally, we have shown a clear worsening of radiological humeroulnar osteoarthritis and capitellar lesions, that remained asymptomatic.
BACKGROUND: Several studies have already reported good short-term results in pyrocarbon unipolar radial head prosthesis (Pyc-uRHP). The aim was to evaluate the evolution from mid-term to long-term clinical and radiographic outcomes of a Pyc-uRHP. METHODS: It was a retrospective, monocentric study. We followed all the patients who undergone Pyc-uRHP surgery from our original study at 2 years of follow-up (52 patients) to reach a minimum of 7 years of clinical and radiological follow-up. 26 patients were included at a mean follow-up of 110 months (78-162 months)) for a clinical examination with mobility, Mayo Elbow Performance Score (MEPS), VAS and radiological evaluation with A/P and profile X-rays. The radiological study analyzed signs of proximal osteolysis, stem loosening, capitellar wear and humero-ulnar osteoarthritis. RESULTS: No patients required revision. Eight patients required reoperation: 1 coronoid screw removal and 7 arthrolysis for stiffness. The mean time to reoperation was 11 months. The mean MEPS at last follow-up was 96±9/100, with pain 42±7/45, mobility 19±2/20, stability 10/10 and function 25/25. Comparison with clinical data from the mid-term delay did not reveal any significant difference. All patients presented a proximal osteolysis around the neck but without progression. No stem loosening was noticed. Humeroulnar osteoarthritis (12% at mid-term vs 80% at last follow-up, p<0.0001) and capitellar lesions (34% at mid-term vs 80% at last follow-up, p=0.001) increased significantly. CONCLUSION: We have shown that a Pyc-uRHP at 9 years follow-up provided stable and satisfactory clinical results. Osteolysis of the radial neck is always present, but it did not evolve, and no stem loosening was noticed. Finally, we have shown a clear worsening of radiological humeroulnar osteoarthritis and capitellar lesions, that remained asymptomatic.