Radiolucencies surrounding a smooth-stemmed radial head component may not correlate with forearm pain or poor elbow function

Radial Head Arthroplasty: A Radiologic Outcome Study

“…Previous studies have reported some, but not all, radiographic findings [14,15,17,18]. In our study, the three most common radiographic complications were heterotopic ossification, radiocapitellar osteoarthritis, and hardware loosening.…”

“…Many of these studies are limited by small sample sizes, most involving fewer than 20 implants, with a study by Popovic et al [17] being the largest, with 51 implants. With unipolar implants, asymptomatic less than 2 mm lucency about the radial stem was commonly reported; Fehringer et al [15] reported this finding in 16 of 17 total implants. Although this finding persisted in all 20 implants in the only long-term study of unipolar types, by Harrington et al [20], its clinical significance is still unknown.…”

“…So far, intermediate-term follow-up studies on radial head arthroplasty for both unipolar and bipolar types have concentrated on clinical outcomes, such as patient satisfaction, subjective pain level, and range of motion [14][15][16][17][18][19][20]. All have reported favorable clinical outcome, with low rates of revision surgeries.…”

Mid- to long-term results after bipolar radial head arthroplasty

“…1,5,19,25 It has, therefore, superseded radial head resection as the treatment of choice for unreconstructable radial head fractures. 19,24,31 In many studies, encouraging short-term results have been reported for monobloc as well as bipolar implants 3,[7][8][9]12,17,18,21,23,27,32,34 ; but, there still exists a lack of information concerning long-term results.…”

“…Fehringer et al did not find a correlation between smooth-stem surrounding radiolucencies and forearm pain or elbow function in the 16 cases of their retrospective study. 8 The observations of Popovic et al have to be interpreted differently, as the authors presumed that only the radiolucent lines that were already visible within the first postoperative year and remained stable overtime are the result of an insufficient cementing technique, and that the progressive radiolucent lines and proximal bone resorption occur due to mechanical factors and wear debris. Because these findings were not noted in any of the numerous short-term studies, 3,12,32,34 nor in Muller's, Dotzis', or Frosch's 5-year studies, 7,9,23 nor in our 8.8-year results of Judet's bipolar radial head prosthesis, one must assume that all these radiologic findings may be the result of an initial insufficient cementing technique, perhaps worsened by mechanical factors and/or wear debris over the years.…”