Radiographic Predictors for Short-term Functional Outcome after Radial Head Arthroplasty in Patients with Persistent Symptoms after Treatment for Radial Head

Abstract

Background: Evaluation of the accurate position after radial head arthroplasty remains a challenge for surgeons.<br />Standard radiographs are used to evaluate the position of the implant, however, results regarding radiographic<br />deficiencies on clinical outcome are not consistent. In this retrospective study our main aim was to determine if subtle<br />radiographic deficiencies after radial head arthroplasty can predict functional outcomes measured with the Mayo Elbow<br />Performance Score (MEPS).<br />Methods: A total of 24 patients, that had a press-fit bipolar radial head arthroplasty because of persistent symptoms<br />after treatment of a radial head fracture, were included. The mean follow-up time was 27 months and the MEPS was<br />assessed at the final follow-up. Three upper extremity orthopaedic surgeons evaluated 12 potential deficiencies on<br />anteroposterior and lateral radiographs in consensus agreement.<br />Results: The median MEPS was 97.5 (Interquartile Range 82.5-100). No association was found between the presence<br />of subtle radiographic deficiencies and MEPS.<br />Conclusion: Functional outcome of the elbow after uncemented press-fit bipolar radial head arthroplasty is not<br />associated with subtle radiographic deficiencies. Therefore, surgeons might accept small imperfections on postoperative<br />radiographs.<br />Level of evidence: IV