After failed radial head arthroplasty, what are the options? Risk factors and results of revisions in a multicenter study.
Capitulum osteoarthritis
Instability
Radial head arthroplasty
Removal
Revision
Journal
Journal of clinical orthopaedics and trauma
ISSN: 0976-5662
Titre abrégé: J Clin Orthop Trauma
Pays: India
ID NLM: 101559469
Informations de publication
Date de publication:
Mar 2023
Mar 2023
Historique:
received:
02
07
2022
revised:
08
12
2022
accepted:
11
02
2023
pmc-release:
13
02
2024
entrez:
2
3
2023
pubmed:
3
3
2023
medline:
3
3
2023
Statut:
epublish
Résumé
Few multicenter studies have analyzed the outcome of revision surgery of radial head arthroplasties (RHA) in the medium term follow up. The objective is twofold: to determine the factors associated with revision of RHAs and to analyze the results of revision with 2 surgical techniques: isolated removal of the RHA or revision with a new RHA (R-RHA). There are associated factors of RHA revision and RHA revision results in satisfactory clinical and functional outcomes. Twenty-eight patients were included in this multicenter retrospective study, with all surgical indications for initial RHA being traumatic/post-traumatic. The mean age was 47 ± 13 years with a mean follow-up of 70 ± 48 months. This series included two groups: the isolated RHA removal group (n = 17) and the revision RHA with new radial head prosthesis (R-RHA) group (n = 11). Evaluation was clinical and radiological with univariate and multivariate analysis. Two factors associated with RHA revision were identified: a pre-existing capitellar lesion (p = 0.047) and a RHA placed for a secondary indication (<0.001). Revision for all 28 patients resulted in improved pain (pre-op Visual Analog Scale 4.7 ± 3 vs. post-op 1.57 ± 2.2, p < 0.001), mobilities (pre-op flexion 118 ± 20 vs. post-op 130 ± 13, p = 0.03; pre-op extension -30 ± 21 vs post-op -20 ± 15, p = 0.025; pre-op pronation 59 ± 12 vs post-op 72 ± 17, p = 0.04; pre-op supination 48 ± 2 vs post-op 65 ± 22, p = 0.027) and functional scores. Mobility and pain control were, for stable elbows, satisfactory in the isolated removal group. When the initial or revision indication was instability, the DASH (Disabilities of the Arm, Shoulder and Hand = 10 ± 5) and MEPS (Mayo Elbow Performance score = 85 ± 16) scores were satisfactory in the R-RHA group. In the case of a radial head fracture, RHA is a satisfactory first-line solution without pre-existing capitellar injury, its results being much weaker in the case of ORIF failure and fracture sequelae. In case of RHA revision, isolated removal or R-RHA adapted according to the pre-operative radio-clinical exam. IV.
Identifiants
pubmed: 36860992
doi: 10.1016/j.jcot.2023.102128
pii: S0976-5662(23)00036-X
pmc: PMC9969247
doi:
Types de publication
Journal Article
Langues
eng
Pagination
102128Informations de copyright
© 2023 Delhi Orthopedic Association. All rights reserved.
Déclaration de conflit d'intérêts
None.
Références
J Bone Joint Surg Br. 2007 Mar;89(3):413-6
pubmed: 17356163
Egypt J Immunol. 2013;20(2):93-9
pubmed: 24624484
J Bone Joint Surg Am. 2002 Oct;84(10):1811-5
pubmed: 12377912
Int Orthop. 2017 Jul;41(7):1435-1443
pubmed: 28500495
Bone Joint J. 2013 Oct;95-B(10):1383-7
pubmed: 24078536
Orthop Traumatol Surg Res. 2021 Apr;107(2):102826
pubmed: 33516892
JBJS Rev. 2016 Oct 18;4(10):
pubmed: 27792673
Orthop Traumatol Surg Res. 2021 Apr;107(2):102645
pubmed: 32768276
Orthop Traumatol Surg Res. 2015 Oct;101(6):729-34
pubmed: 26321464
J Shoulder Elbow Surg. 2008 Mar-Apr;17(2):e12-5
pubmed: 17967550
J Shoulder Elbow Surg. 2012 Jan;21(1):92-7
pubmed: 21856175
Am J Ind Med. 1996 Jun;29(6):602-8
pubmed: 8773720
J Bone Joint Surg Am. 2004 May;86(5):1061-4
pubmed: 15118054
Orthop Traumatol Surg Res. 2018 Oct;104(6):853-857
pubmed: 29581069
J Bone Joint Surg Br. 2011 Oct;93(10):1389-94
pubmed: 21969440
J Bone Joint Surg Am. 2002 Nov;84(11):1970-6
pubmed: 12429757
Orthop Traumatol Surg Res. 2017 Apr;103(2):183-189
pubmed: 27940249
Injury. 2016 Jun;47(6):1253-7
pubmed: 26975795
Bone Joint J. 2017 Sep;99-B(9):1197-1203
pubmed: 28860400
Bone Joint J. 2019 Nov;101-B(11):1362-1369
pubmed: 31674247
J Bone Joint Surg Am. 1981 Jul;63(6):872-7
pubmed: 7240327
Clin Orthop Relat Res. 1967 Jan-Feb;50:71-86
pubmed: 6029027
EFORT Open Rev. 2020 Jan 28;4(12):659-667
pubmed: 32010454
Clin Orthop Relat Res. 2014 Feb;472(2):727-31
pubmed: 24030626
Bone Joint J. 2019 Dec;101-B(12):1512-1519
pubmed: 31787006
JSES Int. 2020 Feb 29;4(1):30-38
pubmed: 32195463
Bone Joint J. 2017 Dec;99-B(12):1561-1570
pubmed: 29212677
Arch Bone Jt Surg. 2015 Apr;3(2):88-93
pubmed: 26110173
EFORT Open Rev. 2020 Aug 1;5(7):398-407
pubmed: 32818067
Orthop Traumatol Surg Res. 2016 Feb;102(1 Suppl):S69-79
pubmed: 26796996
J Bone Joint Surg Am. 2009 Jul;91(7):1738-46
pubmed: 19571097
Clin Orthop Relat Res. 2019 Nov;477(11):2531-2540
pubmed: 31389899
J Bone Joint Surg Am. 1986 Jun;68(5):669-74
pubmed: 3722222
J Shoulder Elbow Surg. 2017 Mar;26(3):394-402
pubmed: 27887874
Clin Orthop Relat Res. 2014 Jul;472(7):2136-43
pubmed: 24549774
J Bone Joint Surg Am. 2004 Feb;86(2):274-80
pubmed: 14960671
Med Eng Phys. 2005 May;27(4):336-42
pubmed: 15823475
Orthop Traumatol Surg Res. 2014 Nov;100(7):703-9
pubmed: 25281556
Orthop Traumatol Surg Res. 2010 Oct;96(6):702-5
pubmed: 20702154
J Bone Joint Surg Am. 1991 Mar;73(3):440-6
pubmed: 2002081
Int Orthop. 2014 Nov;38(11):2295-301
pubmed: 25082181
Orthop Traumatol Surg Res. 2021 Apr;107(2):102818
pubmed: 33484903
J Hand Surg Am. 2014 Jun;39(6):1146-50
pubmed: 24656392
Orthop Traumatol Surg Res. 2020 Apr;106(2):311-317
pubmed: 32173303