Mid- to long-term results after bipolar radial head arthroplasty.
BACKGROUND
Radial head arthroplasty is considered the treatment of choice for unreconstructable radial head fractures in the acute fracture situation. Although short-term results in the current literature are promising, replacement of the radial head remains controversial as long-term results are still missing. We report our 8.8-year results after treatment with a bipolar radial head prosthesis by Judet.


METHODS
In our department, 19 patients were treated with bipolar radial head arthroplasty between 1997 and 2001. Seventeen of these patients-14 men and 3 women-were examined retrospectively after 106 months (range, 78-139). Of these, 9 patients were treated primarily, 7 patients secondarily, and 1 because of a tumor.


RESULTS
On the Mayo Elbow Performance Score, 6 patients achieved excellent results, 10 good, and one fair. The mean DASH score was 9.8 (range, 0-34). No differences were seen between primary and secondary implantation. Flexion averaged 124° (range, 110-150°), the extension deficit was 21° (range, 0-40°), pronation 64° (range, 30-90°), and supination 64° (range, 30-90°). The following complications were seen: 2 dislocations and 8 cases of degenerative changes of the capitellum, 1 with severe erosion. Signs of ulnohumeral arthrosis were found in 12 patients. No evidence of loosening, radiolucencies, or proximal bone resorption was detected.


CONCLUSIONS
Despite major primary complications and high incidence of radiographic signs of degenerative changes after 8.8 years, mainly good clinical results were achieved with Judet's bipolar prosthesis.
Burkhart
Klaus Josef
KJ
Department for Trauma Surgery, Center for Musculosceletal Surgery, Johannes Gutenberg-University, Mainz, Germany. burkhart@unfall.klinik.uni-mainz.de
Mattyasovszky
Stefan G
SG
Runkel
Martin
M
Schwarz
Christina
C
Küchle
Raphael
R
Hessmann
Martin H
MH
Rommens
Pol M
PM
Lars
Müller P
MP
D019643:Arthroplasty, Replacement / Q000379:methods*; D005260:Female; D006801:Humans; D007595:Joint Prosthesis; D008297:Male; D011885:Radius Fractures / Q000601:surgery*; D016896:Treatment Outcome