Radial Head Arthroplasty: A Radiologic Outcome Study

Abstract

The purpose of this study is to provide a radiographic outcome assessment of radial head arthroplasty in correlation with clinical outcomes and to determine whether there is an association between certain patient factors and clinical and radiographic outcomes. A 10-year retrospective review was performed to identify patients with metal radial head arthroplasty. At least two follow-up radiographs were reviewed for each patient and were correlated with clinical information. Statistical analysis included calculation of complication rates, phi coefficient for variable association with complications, and Kaplan-Meier survival. A total of 258 radial head implants in 244 patients were reviewed. The mean patient age was 46 years, with mean follow-up time of 12.8 months. Two hundred nineteen (84.9%) implants were unipolar in design, whereas 39 implants were bipolar. The most common indication for arthroplasty was trauma (94% acute and 2% failed internal fixation). Radiographic abnormalities included nonbridging heterotopic ossification (38.0%), secondary radiocapitellar joint osteoarthritis (27.9%), loosening (19.8%), bridging heterotopic ossification (8.9%), fracture (2.3%), and hardware dislocation (2.7%). Overall, there were 62 second surgeries for either revision or removal. Reasons for second surgery included heterotopic ossification (53.2%), synovectomy or capsulectomy (43.5%), and infection (3.2%). There was a statistically significant association between radiographic complications and the presence of patient symptoms (p < 0.05). There was no association between radiographic or clinical complications with age, sex, side, or type of arthroplasty (R < 0.001). There is a positive association between radiographic findings and patient symptoms for postoperative complications after radial head arthroplasty. By 9 months, 50% of implants showed radiographic complications.