Long-Term Follow-up of Modular Metallic Radial Head Replacement: Commentary on an article by Jonathan P. Marsh, MD, FRCSC, et al.: "Radial Head Fractures Treated with Modular Metallic Radial Head Replacement: Outcomes at a Mean Follow-up of Eight Years".

Abstract

Radial head arthroplasty is used to stabilize the joint after a complex acute radial head fracture that is not amenable for fixation or to treat sequelae of radial head fractures. Most of the currently used radial head prostheses are metallic monoblock implants that are not consistently adaptable and raise technical challenges since their implantation requires lateral elbow subluxation. Metallic modular radial head arthroplasty implants available in various head and stem sizes have been developed to improve adaptability and facilitate implantation. Bipolar radial head arthroplasty implants were developed to improve articular tracking of the prosthesis on the capitellum. Previously published studies do not allow comparisons across implants, as no comparative studies are available and indications vary with each type of implant. A meta-analysis of the published case series suggested that the outcomes are satisfactory for 81% of patients managed in the acute setting and for 73% of those managed at the stage of sequelae, after a mean follow-up of three to four years1. The outcomes do not seem to differ significantly for monoblock prostheses (50% to 94% with satisfactory outcomes), modular prostheses with a fixed radial head (61% to 97% with satisfactory outcomes), and bipolar radial head arthroplasty implants (50% to 100% with satisfactory outcomes). …