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

Abstract : INTRODUCTION: The most common reason for removal of well-fixed radial head prostheses is painful loosening. We hypothesised that short-stemmed prostheses, used for radial head arthroplasty, are not associated with an increased risk of implant loosening. METHODS: From 2002 to 2014, 65 patients were enrolled in a retrospective single-centre study. The radial head prostheses were classified as having either a long (30-mm) or short (16- to 22-mm) stem. The long-stemmed implants comprised 30 GUEPAR® DePuy Synthes (West Chester, PA, USA) and 20 Evolutive® Aston Medical (Saint-Etienne, France) devices; the short-stemmed implants comprised nine RECON and six STANDARD rHead® SBI-Stryker (Morrisville, PA, USA) devices. At last follow-up, clinical (range of motion, Disabilities of the Arm, Shoulder, and Hand score, Mayo Elbow Performance score) and radiographic (osteolysis) outcomes were assessed. RESULTS: At a mean follow-up of 76.78 months (24-141), the rate of painful loosening [6 (40%) vs 8 (16%), p = 0.047] and osteolysis [12 (80%) vs 23 (46%), p = 0.02] were significantly higher in patients with short-stemmed versus long-stemmed implants. Despite the significant difference in loosening between stems as groups, individual stem length was not determined. CONCLUSIONS: Tight-fitting implants with short stems are more prone to painful loosening.
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Submitted on : Tuesday, May 21, 2019 - 3:35:56 PM
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Pierre Laumonerie, Nicolas Reina, Claudia Gutierrez, Stephanie Delclaux, Meagan E. Tibbo, et al.. Tight-fitting radial head prosthesis: does stem size help prevent painful loosening?. International Orthopaedics, Springer Verlag, 2018, 42 (1), pp.161-167. ⟨10.1007/s00264-017-3644-6⟩. ⟨hal-02135801⟩

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