Radiographic and clinical comparisons between loose-fit and press-fit stems in monopolar radial head arthroplasty for comminuted radial head fractures

Haruhiko Shimura; Yoshiaki Wakabayashi; Tetsuya Yamada; Ken Shirakawa; Tetsuya Sato; Koji Fujita; Yumi Niizeki; Shiro Suzuki; Hidetoshi Kaburagi; Hidetsugu Suzuki; Akimoto Nimura

doi:10.1016/j.jos.2024.02.002

Radiographic and clinical comparisons between loose-fit and press-fit stems in monopolar radial head arthroplasty for comminuted radial head fractures

J Orthop Sci. 2024 Feb 10:S0949-2658(24)00014-9. doi: 10.1016/j.jos.2024.02.002. Online ahead of print.

Affiliations

¹ Department of Orthopedic Surgery, Tokyo Bay Urayasu Ichikawa Medical Center. 3-4-32 Todaijima, Urayasu-City, Chiba, 279-0001, Japan. Electronic address: haruhikos@jadecom.jp.
² Department of Orthopaedic Surgery, Hand and Upper Extremity Group, Tokyo Medical and Dental University. 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan.
³ Department of Functional Joint Anatomy, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University. 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan.

PMID: 38342710
DOI: 10.1016/j.jos.2024.02.002

Abstract

Purpose: Few clinical studies have compared the operative outcomes between loose- and press-fit stems in radial head arthroplasty (RHA). We aimed to evaluate the radiographic and clinical results of the two radial head implant concepts.

Methods: In this retrospective multicenter study, 32 patients (24 women and 8 men) with a mean age of 63.1 years who underwent RHA for comminuted radial head fractures were reviewed between 2005 and 2021. Seventeen patients underwent RHA with a loose-fit stem (L-group), whereas the remaining fifteen patients underwent RHA with a press-fit stem (P-group). The mean follow-up period was 40.1 ± 9.9 months, with the minimum follow-up duration of 12 months. The radiographic findings were evaluated for periprosthetic osteolysis; furthermore, clinical outcomes were analyzed to measure the range of motion of the elbow. The rate of reoperations and prosthesis removal were also reviewed.

Results: The general characteristics of the patients were similar in the two groups. The rate of periprosthetic osteolysis was 17.6% in the L-group, whereas it was 53.3% in the P-group. The mean elbow flexions were 128° and 133° in the L- and P-groups, respectively. The mean elbow extensions were -12° and -9° in the L- and P-groups, respectively. The rate of reoperation was 23.5% in the L-group and 15.2% in the P-group. One patient in the L-group had the prosthesis removed because of surgical site infection, whereas one patient in the P-group had the prosthesis removed owing to painful loosening.

Conclusions: No significant differences in the clinical outcomes and reoperation rate were observed between the two radial head implant concepts in this study. However, osteolysis occurred more frequently in the P-group. Although patients with periprosthetic osteolysis are currently asymptomatic, they should be carefully followed up for the symptoms in the long term.

Keywords: Loose-fit stem; Osteolysis; Press-fit stem; Radial head arthroplasty; Radial head fracture.