Clinical and radiologic outcomes of pyrocarbon radial head prosthesis: midterm results

Tight-fitting radial head prosthesis: does stem size help prevent painful loosening?

“…Overstuffing was identified in 30 cases at a frequency of 47% (7) for short and 46% (23) for long stems; (p = 0.96). A river delta sign [9] was reported in 11 cases (3 short and 8 long). There was no significant association between implant overstuffing and loosening [OR 0.96 (0.28-3.27); p = 0.95] or osteolysis [OR 0.78 (0.30-2.02); p = 0.62].…”

“…This study shows that the rate of painful loosening was significantly higher in tight-fitting RHPs with short stems (p < 0.05). Despite satisfactory mid-to long-term outcomes (mean quickDASH and MEP scores of 16.57 and 87.4, respectively), tight-fitting RHP may have inferior mid-term survival than loose-fitting implants according to recent literature [5][6][7][8][9][10][11][12][13][14][15]. Painful loosening of tight-fitting implants is the most common cause of RHA failure [15-19, 25, 26].…”

“…Function was assessed using the Mayo Elbow Performance Score (MEPS) and the Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) score [22,23]. For all cases, radiographic analysis of the elbow (lateral/AP views) was used to asses for signs of periprosthetic osteolysis, overstuffing (on lateral radiograph according to the method described by Van Riet et al [24]) and presence or absence of river delta sign (asymmetric humero-ulnar joint space, wider on the radial side according to Gauci et al [9]). Assessment included heterotopic ossification according to Brooker classification and capitellar wear.…”

“…This becomes important when one considers that the proximal radius is a major contributor to elbow and forearm stability [2][3][4]. Radial head arthroplasty (RHA) bas satisfactory out cornes according to recent Iiterature [5][6][7][8]; however, tight fitting radial head prostheses (RHP) may have inferior rnid term survival than loose-fitting implants [5][6][7][8][9][10][11][12][13][14]. High compli cation rates have been reported after this procedure, and the most common cause of RHP removal is painful prosthetic loosening [15][16][17][18][19].…”

Radiuskopf

“…Durch die Überlänge des "Radius" kommt es auch zu einem Aufklappen der Gelenkfläche zwischen Trochlea und der Coronoidbasis, zum sog. "River-Delta-Sign" [7]. Dieses Phä-nomen wird auch als "gapping" des Humeroulnargelenks bezeichnet [17].…”