title: Cemented bipolar radial head arthroplasty: midterm follow-up results.
abstract: BACKGROUND
  Theoretical advantages of bipolar over monopolar radial head arthroplasty include better accommodation of radiocapitellar malalignment, reduction of capitellar abrasion, and reduction of stress at the bone-to-cement and cement-to-implant interfaces. Our purpose was to report the midterm results of cemented bipolar radial head arthroplasty.
  
  
  METHODS
  Twenty-five patients were treated by cemented bipolar radial head arthroplasty for acute fracture of the radial head, earlier treatment that had failed, or posttraumatic sequelae. One patient refused follow-up after surgery. Results are presented for the remaining 24 patients.
  
  
  RESULTS
  At a mean follow-up of 50 months (range, 24-72 months), 1 prosthesis (4%) had been removed 2 years after implantation for dissociation of the prosthesis due to failure of the snap-on mechanism. There were 2 (8%) additional radiologic failures in the subluxated position: 1 prosthesis due to malalignment of the radius onto the capitellum and another due to ulnohumeral erosion. The average flexion-extension arc was 129° (range, 80°-140°), and the average pronation-supination arc was 131° (range, 40°-180°). According to the Mayo Elbow Performance Score, the combined excellent and good results accounted for 83%. In 8 patients, the bipolar design compensated for radiocapitellar malalignment.
  
  
  CONCLUSIONS
  The overall midterm outcome of this series of 25 cemented bipolar radial head arthroplasties can be considered favorable. There was 1 (4%) revision and 2 (8%) additional radiologic failures. The bipolar design was able to compensate for radiocapitellar malalignment. We suggest considering a cemented bipolar radial head prosthesis in case of concerns about radiocapitellar alignment.
authors: Department of Orthopaedic Surgery, Academic Medical Center Amsterdam, Amsterdam, The Netherlands. Electronic address: aheijink@yahoo.com.
authors: Andras
authors: A
authors: Heijink
authors: Department of Orthopaedic Surgery, Academic Medical Center Amsterdam, Amsterdam, The Netherlands.
authors: Izaäk F
authors: IF
authors: Kodde
authors: Department of Orthopaedic Surgery, Amphia Hospital, Breda, The Netherlands.
authors: Paul G H
authors: PGH
authors: Mulder
authors: Department of Orthopaedic Surgery, Academic Medical Center Amsterdam, Amsterdam, The Netherlands.
authors: C Niek
authors: CN
authors: Van Dijk
authors: Department of Orthopaedic Surgery, Amphia Hospital, Breda, The Netherlands.
authors: Denise
authors: D
authors: Eygendaal
mesh_terms: D000328:Adult; D000368:Aged; D057929:Arthroplasty, Replacement, Elbow / Q000379:methods*; D001843:Bone Cements; D058569:Elbow Prosthesis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D063868:Patient Outcome Assessment; D011403:Pronation; D011885:Radius Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D016059:Range of Motion, Articular; D013484:Supination
chemical_list: D001843:Bone Cements
keywords: Elbow; fracture; prosthesis; replacement; trauma; upper extremity