This study is a retrospective review of 31 patients who underwent metallic radial head arthroplasty between 1993 and 2004 for posttraumatic elbow disorders more than four weeks after the initial injury for nonunion, malunion, recurrent instability following a previous radial head excision, or a failed silicone radial head implant. There were thirteen men and nineteen women with a mean age of 54 years (range, 32 to 93 years). According to the Mayo Elbow Performance Score, at a mean follow-up of 8 years (range, 2-14 years), there were seventeen (53%) excellent results, four good results (13%), seven (22%) fair results, and four (13%) poor results. Radiographic evaluation demonstrated that thirty-one of the thirty-two implants articulated congruently with the capitellum with a concentric ulnohumeral joint. There were no cases of clinical loosening or instability of any of the implants despite minor lucency noted around the stem in ten elbows, moderate lucency around the stem in four, and severe lucency around the stem in two. In addition, osteoarthritis was noted to a mild degree in 10 elbows, moderate in 11 and severe in one.
This study reveals adequate functional outcome in patients treated with a metallic radial head for chronic post-traumatic elbow disorders at an average of 8 years. There was a 100% survival of the implant utilized at a maximum of 14 years. Despite over 50% of radiographs showing periprosthetic lucency, there was no progression after the first 2 years of follow-up. In addition, 50% showed capitellar osteopenia and 71% demonstrated arthritis but this did not correlate with outcome.