Rehabilitation protocol after radial head arthroplasty – a single centre experience and narrative review of the literature

Abstract

Radial head fractures are relatively common injuries – they represent about 1.5–4% of all fractures and approximately 1/3 of fractures of the elbow. Nevertheless, treatment algorithms and rehabilitation plans in such injuries still remain controversial. One of the treatment methods is arthroplasty of the radial head. It is suitable for patients classified as II or III Mason type with concomitant instability and limited mobility of the elbow joint. Arthroplasty of the radial head aims at restoring joint stability, as well as early mobilization and rehabilitation. Currently in Poland, 200–250 alloplastic implantations of the radial head are performed per year (according to the Central Database of Arthroplasties) and this number is increasing annually. Consequently, physicians and physiotherapists may face that problem more frequently than only several years ago in their everyday clinical practice. For patients who underwent this type of surgery, there exists no unified, widely accepted rehabilitation protocol, neither in Poland nor worldwide. It has been proven that rehabilitation plays an important role in restoring the functioning of patients after arthroplasty of the radial head; however, it is difficult to find scientific reports and studies with therapeutic schemes that would provide guidelines for physiotherapy, active exercises, manual therapy, and muscle strength improving exercises. The aim of this review is to analyse and compare information about rehabilitation process after surgery of proximal radius that is available in the literature. The authors also present their own experience and results.