title: Outcomes and radiographic findings of anatomic press-fit radial head arthroplasty.
abstract: BACKGROUND
  Radial head arthroplasty (RHA) is a popular method of treatment for complex fractures of the radial head. The purpose of this study was to investigate patient outcomes and radiographic findings associated with a single anatomic monopolar press-fit radial head system commonly used for the treatment of radial head fractures.
  
  
  METHODS
  A retrospective review of prospectively collected data was performed for a consecutive series of patients treated with a press-fit anatomically designed RHA between November 2007 and April 2014. The most recent radiographs were evaluated for loosening, stress shielding, and instability. Postoperative motion and outcomes were reported at most recent follow-up.
  
  
  RESULTS
  At an average follow-up of 30 months, 6 of the 15 patients (40%) demonstrated radiographic loosening. Six of the 9 patients (67%) without loosening demonstrated stress shielding (average, 6 mm). Functional outcome scores included a mean American Shoulder and Elbow Surgeons score of 70, Mayo Elbow Performance Score of 85, visual analog scale score for pain of 2, visual analog scale score for function of 7, and Single Assessment Numeric Evaluation score of 75. Average flexion-extension arc was 14° to 138°, and average pronation-supination was 75° to 74°. All 6 of the patients with radiographic loosening had undergone RHA with an associated ligamentous injury repair. Satisfaction among patients was high as no patient reported an unsatisfactory outcome.
  
  
  CONCLUSIONS
  The use of an anatomic, press-fit monopolar RHA in the management of acute complex radial head fractures has yielded excellent clinical outcomes despite high rates of radiographic loosening and stress shielding. Press-fit RHA in the setting of ligamentous injury warrants further investigation because of a high rate of implant loosening observed.
authors.affiliation: Holy Cross Orthopedic Institute, Fort Lauderdale, FL, USA. Electronic address: jonlevy123@yahoo.com.
authors.forename: Jonathan C
authors.initials: JC
authors.lastname: Levy
authors.affiliation: Holy Cross Orthopedic Institute, Fort Lauderdale, FL, USA.
authors.forename: Nathan T
authors.initials: NT
authors.lastname: Formaini
authors.affiliation: Holy Cross Orthopedic Institute, Fort Lauderdale, FL, USA.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Kurowicki
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001178:Arthroplasty / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D004551:Elbow Joint / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D058569:Elbow Prosthesis / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D057072:Intra-Articular Fractures / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000209:etiology; D017060:Patient Satisfaction; D011475:Prosthesis Failure; D011859:Radiography; D011885:Radius Fractures / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Radial head arthroplasty; complex radial head fracture; press-fit radial implant; terrible triad