title: Clinical and radiographic outcome of revision surgery of radial head prostheses: midterm results in 16 patients.
abstract: BACKGROUND
  Little is known about revision surgery of radial head arthroplasty. The aim of this study was to report on the clinical and radiographic outcome of revision arthroplasty of the elbow with a bipolar metallic radial head prosthesis.
  
  
  METHODS
  Between 2006 and 2013, we used either a press-fit or cemented RHS bipolar radial head prosthesis for revision surgery of radial head arthroplasty in 16 patients. Patients were prospectively enrolled in the study. Differences in outcome parameters before and after revision surgery were compared.
  
  
  RESULTS
  At a mean follow-up of 75 months (range, 36-116 months), none of the revised radial head prostheses needed a second revision. None of the stems showed radiographic signs of loosening. In 1 patient the head was dissociated from the prosthesis. The average flexion-extension arc was 127° (range, 105°-140°), and the average pronation-supination arc was 138° (range, 90°-160°). Stability scores improved after revision surgery, resulting in 13 stable elbows (P = .01). In 8 patients the Oxford Elbow Score was between 37 and 48 points. The percentage of patients with either good or excellent results according to the Mayo Elbow Performance Score was 63%. The mean score on the EQ-5D (EuroQol Five Dimensions) was 80 (range, 63-100), and the visual analog scale scores both for pain at rest and for pain with activity improved to 3 (range, 0-9) and 4 (range, 0-9), respectively (P < .001). All but 1 patient was satisfied with the results of the revision procedure.
  
  
  CONCLUSIONS
  The clinical and radiographic outcomes of revision surgery of a radial head prostheses are favorable.
authors.affiliation: Upper Limb Unit, Department of Orthopaedic Surgery, Amphia Hospital, Breda, The Netherlands. Electronic address: jetskeviveen@gmail.com.
authors.forename: Jetske
authors.initials: J
authors.lastname: Viveen
authors.affiliation: Upper Limb Unit, Department of Orthopaedic Surgery, Amphia Hospital, Breda, The Netherlands; Department of Orthopaedic Surgery, University of Amsterdam, Amsterdam-Zuidoost, The Netherlands.
authors.forename: Izaäk F
authors.initials: IF
authors.lastname: Kodde
authors.affiliation: Foundation for Orthopedic Research, Care & Education, Amphia Hospital, Breda, The Netherlands.
authors.forename: Koen L M
authors.initials: KL
authors.lastname: Koenraadt
authors.affiliation: Upper Limb Unit, Department of Orthopaedic Surgery, Amphia Hospital, Breda, The Netherlands.
authors.forename: Annechien
authors.initials: A
authors.lastname: Beumer
authors.affiliation: Upper Limb Unit, Department of Orthopaedic Surgery, Amphia Hospital, Breda, The Netherlands.
authors.forename: Bertram
authors.initials: B
authors.lastname: The
authors.affiliation: Upper Limb Unit, Department of Orthopaedic Surgery, Amphia Hospital, Breda, The Netherlands; Department of Orthopaedic Surgery, University of Amsterdam, Amsterdam-Zuidoost, The Netherlands.
authors.forename: Denise
authors.initials: D
authors.lastname: Eygendaal
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004551:Elbow Joint / Q000601:surgery*; D058569:Elbow Prosthesis; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D011885:Radius Fractures / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D016059:Range of Motion, Articular; D012086:Reoperation; D016896:Treatment Outcome; D000092464:Elbow Injuries
keywords: Elbow; arthroplasty; bipolar; outcome; prosthesis; radial head; revision