Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2020 Aug 1;5(7):398-407.
doi: 10.1302/2058-5241.5.190055. eCollection 2020 Jul.

Management of the failed radial head arthroplasty

Izaäk F Kodde  1   2 , Jetske Viveen  3 , Bertram The  3 , Roger P van Riet  1 , Denise Eygendaal  3   4
Affiliations
Review

Management of the failed radial head arthroplasty

Izaäk F Kodde et al. EFORT Open Rev. .

Abstract

Primary radial head arthroplasty (RHA) produces good or excellent results in approximately 85% of patients. However, complications are not uncommon and have been described in up to 23% of cases.The number of RHA is increasing, and consequently the absolute number of complications is expected to rise as well. The decision on whether to revise or remove the prosthesis seems more likely to depend on the preference of the surgeon or the hospital, rather than on objectifying problems with the prosthesis.The current article presents an algorithm for the work-up and treatment of most complications that can occur following RHA.Five subgroups of problems were identified: osteoarthritis, stiffness, instability, infection and implant-related issues.In short, the preferred treatment depends mainly on the chondral condition and stability of the elbow joint. Cite this article: EFORT Open Rev 2020;5:398-407. DOI: 10.1302/2058-5241.5.190055.

Keywords: arthroplasty; complications; elbow; prosthesis; radial head; revision.

PubMed Disclaimer

Conflict of interest statement

ICMJE Conflict of interest statement: RVR reports consultancy, payment for lectures including service on speakers bureaus and payment for development of educational presentations for Acumed, outside the submitted work. DE reports consultancy for scientific and educational events for LIMA, and patents/patents pending for international education events for AO International and IBRA, outside the submitted work. The other authors declare no conflict of interest relevant to this work.

Figures

Fig. 1
Fig. 1
Flowchart for the management of the failed radial head arthroplasty (RHA). The flowchart should be interpreted with the details provided in the text.
Fig. 2
Fig. 2
This patient had been treated with a radiocapitellar arthroplasty for posttraumatic arthritis. The radial head component had been removed, and not replaced, due to loosening. Months later the patient presented to our clinic with severe pain and instability. As the original component was no longer available at the time of the second revision, the radial head component was revised with 2 mm of underlengthening, and a patient-specific head that was compatible with the existing capitellar implant.
Fig. 3
Fig. 3
Subluxation of the radial head prosthesis (RHP) with malalignment and after lateral collateral ligament (LCL) repair.
See this image and copyright information in PMC

References

    1. Halls AA, Travill A. Transmission of pressures across the elbow joint. Anat Rec 1964;150:243–247. - PubMed
    1. Morrey BF, An KN. Stability of the elbow: osseous constraints. J Shoulder Elbow Surg 2005;14:174S–178S. - PubMed
    1. Morrey BF, Tanaka S, An KN. Valgus stability of the elbow: a definition of primary and secondary constraints. Clin Orthop Relat Res 1991;265:187–195. - PubMed
    1. Day JS, Lau E, Ong KL, Williams GR, Ramsey ML, Kurtz SM. Prevalence and projections of total shoulder and elbow arthroplasty in the United States to 2015. J Shoulder Elbow Surg 2010;19:1115–1120. - PubMed
    1. Sershon RA, Luchetti TJ, Cohen MS, Wysocki RW. Radial head replacement with a bipolar system: an average 10-year follow-up. J Shoulder Elbow Surg 2018;27:e38–e44. - PubMed

LinkOut - more resources