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Archives of Orthopaedic and Trauma Surgery

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01-05-2021 | Radial Head Fracture | Trauma Surgery

Mid-term clinical outcome comparison of long-stemmed monopolar osseointegrated and short-stemmed bipolar radial head prostheses

Authors: Yves Gramlich, Eva Krausch, Thomas Stein, Kai Schmidt-Horlohé, Reinhard Hoffmann, Alexander Klug

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 5/2021

Abstract

Introduction

Comparative data to guide implant choice for radial head replacements are lacking. Here, we compared the clinical results achieved using two different types of radial head prostheses.

Methods

Data from patients with comminuted radial head fractures (n = 66), who underwent radial head arthroplasty with either short-stemmed bipolar (n = 31, Group 1: rHead Small Bone Innovations/USA) or monopolar long-stemmed osseointegrated rigidly fixed (n = 35, Group 2: MoPyC Tornier/France) prostheses, were retrospectively reviewed. Patients were followed-up for an average of 42 months (16–64 months). Range of elbow motion, elbow stability, grip strength, and visual analog scale (VAS) pain were measured, and functional outcome assessed using the Mayo Elbow Performance Score, the Disability of Arm, Shoulder and Hand questionnaire, and the Broberg–Morrey Score. Complications were analyzed and revision surgeries recorded.

Results

Most patients achieved good/excellent results for all assessed outcome variables, with no significant differences between the two implant groups; however, regardless of the prosthesis type, a mean extension deficit of 18.5° ± 1.7° remained at latest follow-up. Although complication and surgical revision rates were comparable (bipolar, 23%; monopolar, 18%), significantly more bipolar prostheses were explanted because of painful loosening (16% vs. 3%; p = 0.029).

Conclusion

Good to excellent mid-term results for radial head arthroplasty of comminuted radial head fractures can be achieved using both a bipolar and a monopolar radial head implant; however, the monopolar implant may be preferable, as it had a lower rate of painful loosening. Extension deficit occurs regularly.

Level of evidence

Level III Retrospective comparative treatment study.

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Title: Mid-term clinical outcome comparison of long-stemmed monopolar osseointegrated and short-stemmed bipolar radial head prostheses
Authors: Yves Gramlich
Eva Krausch
Thomas Stein
Kai Schmidt-Horlohé
Reinhard Hoffmann
Alexander Klug
Publication date: 01-05-2021
Publisher: Springer Berlin Heidelberg
Keywords: Radial Head Fracture
Radial Head Fracture
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 5/2021
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-020-03534-z

At a glance: The STEP trials

Springer Medicine

Mid-term clinical outcome comparison of long-stemmed monopolar osseointegrated and short-stemmed bipolar radial head prostheses

Abstract

Introduction

Methods

Results

Conclusion

Level of evidence

At a glance: The STEP trials

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusion

Level of evidence

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