title: Press-fit bipolar radial head arthroplasty, midterm results.
abstract: BACKGROUND
  Theoretical advantages of bipolar compared with monopolar radial head arthroplasty include better accommodation of radiocapitellar malalignment, reduction of capitellar abrasion, and reduction of stress at the bone-implant interfaces. Our purpose was to report the midterm results of press-fit bipolar radial head arthroplasty.
  
  
  METHODS
  Thirty patients were treated by press-fit bipolar radial head arthroplasty for acute fracture of the radial head, failed earlier treatment, or post-traumatic sequelae. Three patients were lost to follow-up. Results are presented for the remaining 27 patients.
  
  
  RESULTS
  At mean follow-up of 48 months (range, 28-73), there had been 3 (11%) revisions. Two involved conversion to prosthetic radiocapitellar hemiarthroplasty for symptomatic capitellar abrasion; a third involved exchange of the articular component (ie, head) for instability. In all, the stems appeared well fixed. A prosthesis in a subluxed position accounted for the 1 (4%) additional radiologic failure. The average flexion-extension arc was 136° (range, 120°-145°), and the average pronation-supination arc was 138° (range, 70°-180°). According to the Mayo Elbow Performance Score, the combined excellent and good results accounted for 70%.
  
  
  CONCLUSIONS
  The overall midterm outcome of this series of 30 press-fit bipolar radial head arthroplasties can be considered favorable. Although the revision rate was 11%, the stems were well fixed in all. There was 1 (4%) additional radiologic failure. We suggest considering a press-fit bipolar radial head prosthesis for acute comminuted radial head fractures with limited bone loss of the proximal radius.
authors.affiliation: Department of Orthopedic Surgery, Amphia Hospital, Breda, The Netherlands; Department of Orthopedic Surgery, Academic Medical Center, Amsterdam, The Netherlands. Electronic address: if.kodde@hotmail.com.
authors.forename: Izaäk F
authors.initials: IF
authors.lastname: Kodde
authors.affiliation: Department of Orthopedic Surgery, Amphia Hospital, Breda, The Netherlands; Department of Orthopedic Surgery, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Andras
authors.initials: A
authors.lastname: Heijink
authors.affiliation: Department of Orthopedic Surgery, Amphia Hospital, Breda, The Netherlands.
authors.forename: Laurens
authors.initials: L
authors.lastname: Kaas
authors.affiliation: Consulting Biostatistician, Amphia Hospital, Breda, The Netherlands.
authors.forename: Paul G H
authors.initials: PG
authors.lastname: Mulder
authors.affiliation: Department of Orthopedic Surgery, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: C Niek
authors.initials: CN
authors.lastname: van Dijk
authors.affiliation: Department of Orthopedic Surgery, Amphia Hospital, Breda, The Netherlands.
authors.forename: Denise
authors.initials: D
authors.lastname: Eygendaal
mesh_terms: D000328:Adult; D000368:Aged; D057929:Arthroplasty, Replacement, Elbow; D058569:Elbow Prosthesis; D005260:Female; D005500:Follow-Up Studies; D018460:Fractures, Comminuted / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D011885:Radius Fractures / Q000601:surgery*; D016059:Range of Motion, Articular; D012086:Reoperation; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
keywords: Elbow; fracture; prosthesis; radius; replacement; trauma