Abstract
BackgroundThe aim of this study is to describe the mid-term radiological findings appearing in patients with a pyrocarbon radial head prosthesis, and to correlate them to patient symptoms.Materials and methodsWe review 18 patients who underwent radial head implantation of the MoPyC prosthesis between 2004 and 2015, due to unreconstructible radial head fractures. The clinical outcomes were assessed with Mayo Elbow Performance Score (MEPS). Range of motion, pain, and elbow radiological assessments were recorded. A non-parametric, statistical analysis was carried out to assess the radiological findings with the clinical outcomes.ResultsWe have found that after a mean follow-up of 6.5 years (2–11 years), patients have recovered a median flexion arch of 113°, therefore 77% are classed as satisfactory outcomes and the average MEPS score is 89.5. The presence of periprosthetic changes on X-ray is highly frequent—we found radiolucent lines in 38% of cases, radial neck re-absorption in 83%, and arthrosic changes in 78%. However, the differences found when correlating these changes with the clinical results have not been statistically significant (p > 0.05).ConclusionsSatisfactory outcomes can be expected midterm when using pyrocarbon prostheses in around 75% of the cases. We consider radial neck re-absorption to be a sign of good stem osteointegration, whereas progressive radiolucencies and loss of the ballooning of the stem legs are signs of bad prognosis in our series.Level of EvidenceIV retrospective case series.
Highlights
We have found that after a mean follow-up of 6.5 years (2–11 years), patients have recovered a median flexion arch of 113°, 77% are classed as satisfactory outcomes and the average Mayo Elbow Performance Score (MEPS) score is 89.5
We consider radial neck re-absorption to be a sign of good stem osteointegration, whereas progressive radiolucencies and loss of the ballooning of the stem legs are signs of bad prognosis in our series
The use of radial head prostheses for unreconstructible radial head fractures is becoming increasingly widespread due to the satisfactory results reported in the literature, which occur in the majority of the series in more than 70% of the cases
Summary
The use of radial head prostheses for unreconstructible radial head fractures is becoming increasingly widespread due to the satisfactory results reported in the literature, which occur in the majority of the series in more than 70% of the cases. This is due to the poor results obtained with isolated resection of the radial head without replacing it, which may result in longitudinal radial instability, chronic elbow instability, increases valgus angle, etc. The aim of this study is to describe the mid-term radiological findings appearing in patients with a pyrocarbon radial head prosthesis, and to correlate them to patient symptoms
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