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Revision/Failed Radial Head Arthroplasty

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Arthroplasty of the Upper Extremity

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Abstract

Indications for radial head arthroplasty include significantly comminuted radial head fractures, radial head fractures with concomitant ligamentous injury, and radial head or neck malunions and nonunions. Contemporary prostheses allow for the restoration of elbow motion while preserving joint stability. Studies have demonstrated favorable clinical outcomes and decreased costs of care following radial head arthroplasty when compared to ORIF. However, complications such as aseptic loosening, stiffness, implant failure, arthritis, and infection have all been reported. This chapter will explore the indications, outcomes, complications of radial head arthroplasty, as well as the techniques and indications for revision radial head arthroplasty.

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References

  1. Mason M. Fractures of the head of the radius. Br J Surg. 1954;42:123–32.

    Article  CAS  PubMed  Google Scholar 

  2. Tejwani NC, Mehta H. Fractures of the radial head and neck: current concepts in management. J Am Acad Orthop Surg. 2007;15:380–7.

    Article  PubMed  Google Scholar 

  3. Swensen SJ, et al. Maximizing outcomes in the treatment of radial head fractures. J Orthop Traumatol. 2019;20:15.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Johnston GW. A follow-up of one hundred cases of fracture of the head of the radius with a review of the literature. Ulster Med J. 1962;31:51–6.

    CAS  PubMed  PubMed Central  Google Scholar 

  5. Broberg MA, Morrey B. Results of treatment of fracture-dislocations of the elbow. Clin Orthop Relat Res. 1987;216:109–19.

    Article  Google Scholar 

  6. Hotchkiss R, Displaced N. Fractures of the radial head: internal fixation or excision? J Am Acad Orthop Surg. 1997;5:1–10.

    Article  CAS  PubMed  Google Scholar 

  7. Struijs PAA, Smit G, Steller EP. Radial head fractures: effectiveness of conservative treatment versus surgical intervention. Arch Orthop Trauma Surg. 2007;127:125–30.

    Article  CAS  PubMed  Google Scholar 

  8. Guzzini M, et al. Nonsurgical treatment of Mason type II radial head fractures in athletes. A retrospective study. G di Chir. 2016;37:200–5.

    Google Scholar 

  9. Ring D, Quintero J, Jupier J. Open reduction and internal fixation of fractures of the radial head. J Bone Jt Surg. 2002;84A:1811–5.

    Article  Google Scholar 

  10. Herbertsson P, et al. Fractures of the radial head and neck treated with radial head excision. J Bone Jt Surg. 2004;86:1925–30.

    Article  Google Scholar 

  11. Morrey B, Tanaka S, An K. Valgus stability of the elbow. Clin Orthop Relat Res. 1991;265:187–95.

    Article  Google Scholar 

  12. Beingessner DM, Dunning CE, Gordon KD, Johnson JA, King GJW. The effect of radial head excision and arthroplasty on elbow kinematics and stability. J Bone Jt Surg. 2004;86:1730–9.

    Article  Google Scholar 

  13. Ikeda M, Oka Y. Function after early radial head resection for fracture: a retrospective evaluation of 15 patients followed for 3-18 years. Acta Orthop Scand. 2000;71:191–4.

    Article  CAS  PubMed  Google Scholar 

  14. Harrington IJ, Sekyi-Otu A, Barrington TW, Evans DC, Tuli V. The functional outcome with metallic radial head implants in the treatment of unstable elbow fractures: a long-term review. J Trauma Inj Infect Crit Care. 2001;50:46–52.

    Article  CAS  Google Scholar 

  15. Moro JK, Werier J, MacDermid JC, Patterson SD, King GJW. Arthroplasty with a metal radial head for unreconstructible fractures of the radial head. JBJS. 2001;83:1201–11.

    Article  CAS  Google Scholar 

  16. Ruan HJ, Fan CY, Liu JJ, Zeng BF. A comparative study of internal fixation and prosthesis replacement for radial head fractures of Mason type III. Int Orthop. 2009;33:249–53.

    Article  PubMed  Google Scholar 

  17. Chen X, et al. Comparison between radial head replacement and open reduction and internal fixation in clinical treatment of unstable, multi-fragmented radial head fractures. Int Orthop. 2011;35:1071–6.

    Article  PubMed  Google Scholar 

  18. Laumonerie P, et al. The minimum follow-up required for radial head arthroplasty: a meta-analysis. Bone Jt J. 2017;99B:1561–70.

    Article  Google Scholar 

  19. Laumonerie P, et al. Radial head arthroplasty: a historical perspective. Int Orthop. 2019;43:1643–51.

    Article  PubMed  Google Scholar 

  20. Speed K. Ferrule caps for the head of the radius. Surg Gynecol Obs. 1941;73:845–50.

    Google Scholar 

  21. Swanson AB, Jaeger SH, La Rochelle D. Comminuted fractures of the radial head. The role of silicone implant replacement arthroplasty. J Bone Jt Surg. 1981;63A:1039–49.

    Article  Google Scholar 

  22. Worsing R, Engbera W, Lange T. Reactive synovitis from particular Silastic. J Bone Jt Surg. 1982;64A:581–5.

    Article  Google Scholar 

  23. Mayhall WST, Tiley FT, Paluska DJ. Fracture of silastic radial-head prosthesis. Case report. J Bone Jt Surg Ser A. 1981;63:459–60.

    Article  CAS  Google Scholar 

  24. Gauci MO, Winter M, Dumontier C, Bronsard N, Allieu Y. Clinical and radiologic outcomes of pyrocarbon radial head prosthesis: midterm results. J Shoulder Elb Surg. 2016;25:98–104.

    Article  Google Scholar 

  25. Petscavage JM, Ha AS, Chew FS. Radiologic review of total elbow, radial head, and capitellar resurfacing arthroplasty. Radiographics. 2012;32:129–49.

    Article  PubMed  Google Scholar 

  26. Stuffmann E, Baratz ME. Radial head implant arthroplasty. J Hand Surg Am. 2009;34:745–54.

    Article  PubMed  Google Scholar 

  27. Ha AS, Petscavage JM, Chew FS. Radial head arthroplasty: a radiologic outcome study. Am J Roentgenol. 2012;199:1078–82.

    Article  Google Scholar 

  28. Chanlalit C, Shukla DR, Fitzsimmons JS, An KN, O’Driscoll SW. Stress shielding around radial head prostheses. J Hand Surg Am. 2012;37:2118–25.

    Article  PubMed  Google Scholar 

  29. Burkhart KJ, et al. Mid- to long-term results after bipolar radial head arthroplasty. J Shoulder Elb Surg. 2010;19:965–72.

    Article  Google Scholar 

  30. Bonnevialle N. Radial head replacement in adults with recent fractures. Orthop Traumatol Surg Res. 2016;102:S69–79.

    Article  CAS  PubMed  Google Scholar 

  31. Van Riet RP, Sanchez-Sotelo J, Morrey BF. Failure of metal radial head replacement. J Bone Jt Surg. 2010;92:661–7.

    Article  Google Scholar 

  32. Duckworth AD, Wickramasinghe NR, Clement ND, Court-Brown CM, McQueen MM. Radial head replacement for acute complex fractures: what are the rate and risks factors for revision or removal? Clin Orthop Relat Res. 2014;472:2136–43.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Cristofaro CD, et al. High risk of further surgery after radial head replacement for unstable fractures: longer-term outcomes at a minimum follow-up of 8 years. Clin Orthop Relat Res. 2019;477:2531–40.

    Article  PubMed  PubMed Central  Google Scholar 

  34. Reinhardt, D., Toby, E. B. & Brubacher, J. Reoperation rates and costs of radial head arthroplasty versus open reduction and internal fixation of radial head and neck fractures: a retrospective database study. Hand. 2019. https://doi.org/10.1177/1558944719837691.

  35. Viveen J, et al. Why does radial head arthroplasty fail today? A systematic review of recent literature. EFORT Open Rev. 2019;4:659–67.

    Article  PubMed  Google Scholar 

  36. Flinkkilä T, Kaisto T, Sirniö K, Hyvönen P, Leppilahti J. Short- to mid-term results of metallic press-fit radial head arthroplasty in unstable injuries of the elbow. J Bone Jt Surg Ser B. 2012;94(B):805–10.

    Article  Google Scholar 

  37. Popovic N, Lemaire R, Georis P, Gillet P. Midterm results with a bipolar radial head prosthesis: radiographic evidence of loosening at the bone-cement interface. J Bone Jt Surg - Ser A. 2007;89:2469–76.

    Google Scholar 

  38. Dotzis A, Cochu G, Mabit C, Charissoux JL, Arnaud JP. Comminuted fractures of the radial head treated by the Judet floating radial head prosthesis. J Bone Jt Surg Ser B. 2006;88:760–4.

    Article  CAS  Google Scholar 

  39. Doornberg JN, Parisien R, Van Duijn PJ, Ring D. Radial head arthroplasty with a modular metal spacer to treat acute traumatic elbow instability. J Bone Jt Surg. Ser A. 2007;89:1075–80.

    Article  Google Scholar 

  40. O’Driscoll S, Herald J. Forearm pain associated with loose radial head prosthesis. J Shoulder Elb Surg. 2012;21:92–7.

    Article  Google Scholar 

  41. Mellema JJ, Lindenhovius ALC, Jupiter JB. The posttraumatic stiff elbow: an update. Curr Rev Musculoskelet Med. 2016;9:190–8.

    Article  PubMed  PubMed Central  Google Scholar 

  42. Veltman ES, Doornberg JN, Eygendaal D, van den Bekerom MPJ. Static progressive versus dynamic splinting for posttraumatic elbow stiffness: a systematic review of 232 patients. Arch Orthop Trauma Surg. 2015;135:613–7.

    Article  PubMed  Google Scholar 

  43. Salazar D, Golz A, Israel H, Marra G. Heterotopic ossification of the elbow treated with surgical resection: risk factors, bony ankylosis, and complications. Clin Orthop Relat Res. 2014;472:2269–75.

    Article  PubMed  PubMed Central  Google Scholar 

  44. Yang YJ, et al. A meta-analysis of risk factors for heterotopic ossification after elbow trauma. Int J Clin Exp Med. 2016;9:5308–17.

    CAS  Google Scholar 

  45. Bowman SH, Barfield WR, Slone HS, Shealy GJ, Walton ZJ. The clinical implications of heterotopic ossification in patients treated with radial head replacement for trauma: a case series and review of the literature. J Orthop. 2016;13:272–7.

    Article  PubMed  PubMed Central  Google Scholar 

  46. Van Glabbeek F, et al. Detrimental effects of overstuffing or understuffing with a radial head replacement in the medial collateral-ligament deficient elbow. J Bone Jt Surg. 2004;86:2629–35.

    Article  Google Scholar 

  47. Cohn M, Glait SA, Sapienza A, Kwon YW. Radiocapitellar joint contact pressures following radial head arthroplasty. J Hand Surg Am. 2014;39:1566–71.

    Article  PubMed  Google Scholar 

  48. Kim HM, Roush EP, Kiser C. Intraoperative fluoroscopic assessment of proper prosthetic radial head height. J Shoulder Elb Surg. 2016;25:1874–81.

    Article  Google Scholar 

  49. Athwal GS, et al. Determination of correct implant size in radial head arthroplasty to avoid overlengthening: surgical technique. J Bone Jt Surg Ser A. 2010;92:250–7.

    Article  Google Scholar 

  50. Marinelli A, Guerra E, Ritali A, Cavallo M, Rotini R. Radial head prosthesis: surgical tips and tricks. Musculoskelet Surg. 2017;101:187–96.

    Article  CAS  PubMed  Google Scholar 

  51. Allavena C, et al. Outcomes of bipolar radial head prosthesis to treat complex radial head fractures in 22 patients with a mean follow-up of 50 months. Orthop Traumatol Surg Res. 2014;100:703–9.

    Article  CAS  PubMed  Google Scholar 

  52. Halls AA, Travill A. Transmission of pressures across the elbow joint. Anat Rec. 1964;150:243–7.

    Article  CAS  PubMed  Google Scholar 

  53. Rahmi H, et al. Clinical outcomes of anconeus interposition arthroplasty after radial head resection in native and prosthetic radial heads. J Shoulder Elb Surg. 2018;27:S29–34.

    Article  Google Scholar 

  54. Factor S, et al. Radial head excision and Achilles allograft interposition arthroplasty for the treatment of chronic pediatric radiocapitellar pathologies: a report of four cases. Shoulder Elb. 2020:1758573219897859. https://doi.org/10.1177/1758573219897859.

  55. Neuhaus V, et al. Radial head prosthesis removal: a retrospective case series of 14 patients. Arch Bone Jt Surg. 2015;88:88–93.

    Google Scholar 

  56. Wang X, Fukui K, Yokoyama M, Tsuchiya M, Kaneuji A. Postoperative infection of elbow joint replacement. Transl Surg. 2013;3:57–61.

    CAS  Google Scholar 

  57. Kunutsor SK, Beswick AD, Whitehouse MR, Blom AW. One- and two-stage surgical revision of infected elbow prostheses following total joint replacement: a systematic review. BMC Musculoskelet Disord. 2019;20:1–9.

    Article  Google Scholar 

  58. Kachooei AR, et al. Intraoperative physical examination for diagnosis of interosseous ligament rupture - cadaveric study. J Hand Surg Am. 2015;40:1785–1790.e1.

    Article  PubMed  Google Scholar 

  59. Antuña SA, Sánchez-Márquez JM, Barco R. Long-term results of radial head resection following isolated radial head fractures in patients younger than forty years old. J Bone Jt Surg Ser A. 2010;92:558–66.

    Article  Google Scholar 

  60. Kachooei AR, Baradaran A, Ebrahimzadeh MH, van Dijk CN, Chen N. The rate of radial head prosthesis removal or revision: a systematic review and meta-analysis. J Hand Surg Am. 2018;43:39–53.e1.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Vanderbilt University Department of Orthopedics, Division of Hand Surgery, Nashville, TN, USA

    Emilie J. Amaro, Eric S. Dilbone & Donald H. Lee

  2. Arizona Center for Hand Surgery, Phoenix, AZ, USA

    James P. Hovis

Authors
  1. Emilie J. Amaro
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  2. Eric S. Dilbone
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  3. James P. Hovis
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  4. Donald H. Lee
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Corresponding author

Correspondence to Donald H. Lee .

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Editors and Affiliations

  1. Roth McFarlane Hand & Upper Limb Centre, St Joseph’s Health Care, London, ON, Canada

    Graham J. W. King

  2. Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA

    Marco Rizzo

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Amaro, E.J., Dilbone, E.S., Hovis, J.P., Lee, D.H. (2021). Revision/Failed Radial Head Arthroplasty. In: King, G.J.W., Rizzo, M. (eds) Arthroplasty of the Upper Extremity. Springer, Cham. https://doi.org/10.1007/978-3-030-68880-6_6

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  • DOI: https://doi.org/10.1007/978-3-030-68880-6_6

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  • Online ISBN: 978-3-030-68880-6

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