title: Functional outcomes post-radial head arthroplasty: a systematic review of literature.
abstract: BACKGROUND
  The present study was conducted to determine the quality and content of research on the functional outcomes and complications post-metal radial head arthroplasty (RHAP).
  
  
  METHODS
  A comprehensive search of medical databases for studies reporting on functional outcomes of patients undergoing metallic RHAP was conducted. The Structured Effectiveness Quality Evaluation Scale (SEQES) was used to evaluate quality of the studies.
  
  
  RESULTS
  We identified 21 Sackett's Level IV studies reporting on 391 radial heads. The mean duration of follow-up was 47.2 months and the mean (SD) age of patients was 48.4 years (6.9 years). The male to female ratio was found to be 1.05 : 1 and the dominant arm was involved in 54% of patients. When functional outcomes achieved post-RHAP were compared with normative scores, the comparison suggested that RHAP has good to excellent functional outcomes in short- to mid-term follow-up. The weighted mean (SD) Mayo Elbow Performance Score was 85.8 (4.1) (95% confidence interval 85.3 to 86.3). Incidences of implant removal (3.06%) and revision (2.22%) were found to be low.
  
  
  CONCLUSIONS
  There is consistent low-quality evidence of positive functional outcomes following RHAP. The heterogeneity of type of implant, patient characteristics and outcome measures used, along with an inadequate reporting of study details, restrict any definitive conclusions being made.
authors: School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada; Surgical Outcomes Research Centre (SOURCE), Department of Surgery, McMaster University, Hamilton, ON, Canada.
authors: Manraj Nirmal
authors: MN
authors: Kaur
authors: School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada; Hand and Upper Limb Centre, St. Joseph's Health Centre, London, ON, Canada.
authors: Joy C
authors: JC
authors: MacDermid
authors: Hand and Upper Limb Centre, St. Joseph's Health Centre, London, ON, Canada; St Joseph's Health Centre, University of Western Ontario, London, ON, Canada.
authors: Ruby R
authors: RR
authors: Grewal
authors: School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada.
authors: Paul W
authors: PW
authors: Stratford
authors: Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada.
authors: Linda J
authors: LJ
authors: Woodhouse
keywords: Arthroplasty; arthroplasty; complications; fracture; implant; outcomes; radial head; replacement