Mid- to Long-Term Results after Bipolar Radial Head Arthroplasty

Author(s): Burkhart KJ, Mattyasovszky SG, Runkel M, et al.

Source: J Shoulder Elbow Surg 19(7): 965-72, 2010.

Summary:

This is a mid- to long-term follow-up study of 19 patients treated with a bipolar radial head arthroplasty for fractures.  They were examined at a mean of 106 months following implantation.  The results demonstrate that 6 achieved excellent results, 10 good and 1 fair result with a mean DASH score of 9.8.  The average flexion was at 124°, the average extension deficit was 21° with pronation and supination measuring 64°, respectively.

There were two dislocations, and eight cases with degenerative changes in the capitellum- one with severe erosion.  In addition, signs of ulnohumeral arthrosis were found in 12 patients.  No radiolucencies were detected.

The significance of this review is that even at mid-term follow-up, the results reveal significant arthrosis.  In addition, these patients demonstrate an average arc of motion from 20 – 120 degrees.  While these results may be deemed satisfactory, they indicate that long-term results may be necessary in order to truly determine the effect of metal on cartilage at the radial capitellum articulation.  This is despite the use of a bipolar implant which is designed to theoretically decrease wear on the capitellum.