Radiologic and clinical outcomes of 2 designs (Anatomic Radial Head System and Align) of press-fit anatomic radial head arthroplasty for acute elbow trauma.

BACKGROUND: Different models of radial head arthroplasty have evolved over time, with anatomic press-fit designs currently being widely used. The main complication reported for this type of implant is the development of osteolysis around the stem which has been described in up to 40% of patients and may be associated with the presence of pain and unfavorable clinical outcomes. The aim of this study was to evaluate the clinical and radiologic results of an anatomical press-fit radial head prosthesis and to compare them with those reported for other press-fit stem design.

MATERIAL AND METHODS: A retrospective cohort study was performed. The study cohort consisted of patients who underwent radial head arthroplasty for radial head fractures or terrible triad elbow injuries using the ALIGN (GA) prosthesis at Ramón y Cajal Hospital, Madrid, Spain. The control group comprised patients with the same diagnosis who were treated with a different press-fit stem (GR) arthroplasty, identified from the Ramón y Cajal Hospital registry. Clinical and radiologic evaluations were performed, with specific assessment of the presence of radiolucencies and/or osteolysis, with a minimum follow-up of 2 years. Logistic regression analysis was performed to evaluate the influence of osteolysis on radiological and clinical outcomes.

RESULTS: A total of 15 patients in GA group and 23 patients in GR group were included. The radiolucency rate was 12% in the GA group and 50% in the GR group (P < .05). The presence of radial neck resorption was similar in both groups (53.33% in GA vs 56.52% in GR). Range of motion was comparable between groups, with functional ranges observed in all cases. Functional outcomes scores showed no significant differences between the 2 groups, with satisfactory results in most cases. Residual pain and significative degenerative changes were more prevalent in patients with osteolysis.

CONCLUSIONS: The use of a radial head arthroplasty model with a longer impacted stem aligned with the anatomical axis of the forearm allows for better integration, a low radiolucency rate, and with satisfactory clinical and radiological outcomes at two years of follow-up. Osteolysis was associated with residual pain.