Survivorship of anatomic press-fit short-stem radial head replacement with a pyrocarbon bearing. (August 2022)

• Record Type: Journal Article
• Authors: Viswanath, Aparna I; Watts, Adam C
• Is Part Of: Shoulder & elbow. Volume 14:Number 4(2022)
• Page Start: 426
• Page End: 433
• Publication Date: 2022-08
• Subjects: Fracture -- radial head -- radial head arthroplasty -- elbow fracture-dislocation -- pyrocarbon -- press-fit; Elbow -- Diseases -- Periodicals; Elbow -- Surgery -- Periodicals; Shoulder -- Diseases -- Periodicals; Shoulder -- Surgery -- Periodicals; Shoulder -- Periodicals; Elbow -- Periodicals; Shoulder Joint -- Periodicals; Elbow Joint -- Periodicals; 617.572005
• DOI: 10.1177/17585732211024182
• Languages: English
• ISSNs: 1758-5732

Abstract

Background: Restoring the radial head as a stabiliser of the elbow is considered important in cases where there is an associated bony or ligamentous injury. A variety of radial head prostheses are available. There are no reports of the survivorship of a short-stem press-fit radial head prostheses with pyrocarbon bearing. Patients and methods: With institutional review board approval, a retrospective case-note analysis was performed of a consecutive single-surgeon case series of the Integra LifeScience pyrocarbon radial head prostheses (Carbon Modular Radial Head) from October 2010 to October 2019 in a tertiary referral centre. The series was divided into acute trauma and salvage cohorts. Kaplan–Meier survivorship analysis was conducted. Results: 36 patients were included, 23 (64%) for acute injuries and 13 (36%) for failed initial treatment. Of the acute injuries, 20 (87%) had a Wrightington type-C elbow fracture-dislocation. Reoperation was performed in 4 (11%) patients; 10 (28%) had possible loosening on radiographs. The implant survival rate was 94% at shortest follow-up of 17 months (mean 70 months). Discussion: Treatment of complex radial head fractures using a pyrocarbon-bearing, anatomic press-fit design provides satisfactory short-term survivorship in this case series. The implant should be used with caution in salvage cases, due to higher rates of loosening seen in this cohort.