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12.05.2017 | Original Paper | Ausgabe 7/2017

International Orthopaedics 7/2017

Causes for early and late surgical re-intervention after radial head arthroplasty

Zeitschrift:
International Orthopaedics > Ausgabe 7/2017
Autoren:
Pierre Laumonerie, David Ancelin, Nicolas Reina, Meagan E. Tibbo, Panagiotis Kerezoudis, Stephanie Delclaux, Nicolas Bonnevialle, Pierre Mansat
Wichtige Hinweise
An erratum to this article is available at http://​dx.​doi.​org/​10.​1007/​s00264-017-3526-y.

Abstract

Purpose

The primary objective was to describe the reasons for surgical re-intervention after radial head arthroplasty. The secondary objective was to analyze the radiographic and clinical outcomes after surgical re-intervention at the elbow with implant conservation.

Methods

Among the 70 radial head arthroplasties with bipolar radial head implant performed between 2002 and 2014, 29 required surgical re-interventions. Reasons for surgical re-intervention were gathered from operative notes and follow-up documentation. Patients who underwent re-intervention with implant retention were reassessed via clinical and radiographic examinations by an independent reviewer.

Results

Twenty nine re-operations were performed at a mean follow-up of 16 ± 11.7 months (0.2–36 months). The prosthesis was removed in 18 cases and retained in 11. There was a significant difference in mean time to re-intervention between the implant removal and preservation groups, 23.1 ± 8.3 months (7–36 months) and 4.4 ± 4.7 months (0.2–13 months), respectively (p < 0.001). The primary reason for surgical re-intervention was painful loosening (13 cases). Radio-capitellar instability was the most frequent reason for re-intervention with implant retention (5 cases). Midterm quickDASH and MEPS after surgical re-intervention with implant retention were 15.4 ± 5.4 and 82.27 ± 7.3, respectively. At least one degenerative lesion was reported in nine cases (81.8%) (i.e. 5 periprosthetic osteolysis, 5 capitellar wear, 5 periarticular heterotopic ossification).

Conclusions

Painful loosening and capitellar instability are the primary reasons for surgical re-intervention with or without implant removal. Midterm clinical results are favourable despite an elevated rate of degenerative lesions after surgical re-intervention with implant retention.

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