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Review
. 2020 Jan 28;4(12):659-667.
doi: 10.1302/2058-5241.4.180099. eCollection 2019 Dec.

Why does radial head arthroplasty fail today? A systematic review of recent literature

Jetske Viveen  1   2 , Izaak F Kodde  3 , Andras Heijink  4 , Koen L M Koenraadt  5 , Michel P J van den Bekerom  6 , Denise Eygendaal  2   3
Affiliations
Review

Why does radial head arthroplasty fail today? A systematic review of recent literature

Jetske Viveen et al. EFORT Open Rev. .

Abstract

Since the introduction of the radial head prosthesis (RHP) in 1941, many designs have been introduced. It is not clear whether prosthesis design parameters are related to early failure. The aim of this systematic review is to report on failure modes and to explore the association between implant design and early failure.A search was conducted to identify studies reporting on failed primary RHP. The results are clustered per type of RHP based on: material, fixation technique, modularity, and polarity. Chi-square tests are used to compare reasons for failure between the groups.Thirty-four articles are included involving 152 failed radial head arthroplasties (RHAs) in 152 patients. Eighteen different types of RHPs have been used.The most frequent reasons for revision surgery after RHA are (aseptic) loosening (30%), elbow stiffness (20%) and/or persisting pain (17%). Failure occurs after an average of 34 months (range, 0-348 months; median, 14 months).Press-fit prostheses fail at a higher ratio because of symptomatic loosening than intentionally loose-fit prostheses and prostheses that are fixed with an expandable stem (p < 0.01).Because of the many different types of RHP used to date and the limited numbers and evidence on early failure of RHA, the current data provide no evidence for a specific RHP design. Cite this article: EFORT Open Rev 2019;4:659-667. DOI: 10.1302/2058-5241.4.180099.

Keywords: elbow; failure; radial head prosthesis; removal; replacement; revision.

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Conflict of interest statement

ICMJE Conflict of interest statement: KLMK’s research institution receives financial support from ZimmerBiomet, Stryker and Mathys related and unrelated to specific research projects, but not related to the current work. MPJB reports a research grant from Smith and Nephew and Wright/Tornier for this work. DE reports a research grant and a consulting fee or honorarium from Zimmer Biomet for this work; an Isakos grant and payment for lectures including service on speakers’ bureaus from AO International outside the submitted work. The other authors declare no conflict of interest relevant to this work.

Figures

Fig. 1
Fig. 1
Flowchart. Note. RHP, radial head prosthesis.
Fig. 2
Fig. 2
Failure modes divided per type of fixation. *Press-fit prostheses fail more often because of symptomatic loosening compared to intentionally loose-fit prostheses and prostheses with an expandable stem (p < 0.01). §Intentionally loose-fit prostheses fail more often because of stiffness compared to press-fit protheses (p < 0.01). #Cemented prostheses fail more often because of ulnohumeral arthritis compared to press-fit prostheses and intentionally loose-fit prostheses (p < 0.01).
Fig. 3
Fig. 3
Failure modes divided into monopolar and bipolar. *Bipolar prostheses fail more often because of instability compared to monopolar prostheses (p < 0.01).
See this image and copyright information in PMC

References

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