Clinics in Shoulder and Elbow

대한견·주관절의학회 (Korean Shoulder and Elbow Society)
권호 표지
DOI QR코드

DOI QR Code

Does the polarity of radial head arthroplasty affect functional outcomes? A systematic review and meta-analysis

  • Kofi Agyeman (Department of Orthopaedics, University of Miami, Miller School of Medicine) ;
  • Arya Minaie (Department of Orthopaedics, University of Miami, Miller School of Medicine) ;
  • Seth D. Dodds (Department of Orthopaedics, University of Miami, Miller School of Medicine)
  • 투고 : 2023.12.09
  • 심사 : 2024.01.24
  • 발행 : 2024.06.01
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Background: Radial head arthroplasty allows a high degree of customizability, and implant polarity has emerged as an important variable. The purpose of this meta-analysis was to evaluate differences in functional and clinical outcomes between patients receiving monopolar and bipolar radial head prosthetic implants. Methods: A systematic review and meta-analysis were employed, and 65 articles were identified in three databases. Twelve articles contained non-English or insufficient text and were consequently excluded, and 20 others did not contain sufficient data or follow-up. The remaining 33 articles were qualitatively and quantitatively reviewed. Results: In total, 33 populations were identified, with 809 unduplicated patients: 565 with monopolar and 244 with bipolar implants. In these respective patients, the mean follow-up was 40.2 and 56.9 months. Average Mayo Elbow Performance Score were 86.7 and 87.4 (P=0.80), respectively; average Disability of the Arm, Shoulder, and Hand scores were 17.9 and 14.7 (P=0.47), and average final flexion/extension arcs were 119.4° and 118.7° (P=0.48). Revision rates were 4.07% and 6.56%, while complication rates were 19.65% and 20.08% in the respective monopolar and bipolar patients. These increased relative risks associated with bipolar implants were not significant. Conclusions: Radial head implant polarity does not appear to affect functional outcomes. While bipolar prosthetic design may increase the risks of revision and complications, the increases were not significant. Level of evidence: IV.

키워드

참고문헌

  1. Antoni M, Kempf JF, Clavert P. Comparison of bipolar and monopolar radial head prostheses in elbow fracture-dislocation. Orthop Traumatol Surg Res 2020;106:311-7.  https://doi.org/10.1016/j.otsr.2019.10.027
  2. Acevedo DC, Paxton ES, Kukelyansky I, Abboud J, Ramsey M. Radial head arthroplasty: state of the art. J Am Acad Orthop Surg 2014;22:633-42.  https://doi.org/10.5435/JAAOS-22-10-633
  3. Heijink A, Kodde IF, Mulder PG, et al. Radial head arthroplasty: a systematic review. JBJS Rev 2016;4:e3. 
  4. Pomianowski S, Morrey BF, Neale PG, Park MJ, O'Driscoll SW, An KN. Contribution of monoblock and bipolar radial head prostheses to valgus stability of the elbow. J Bone Joint Surg Am 2001;83:1829-34.  https://doi.org/10.2106/00004623-200112000-00010
  5. Rotini R, Marinelli A, Guerra E, Bettelli G, Cavaciocchi M. Radial head replacement with unipolar and bipolar SBi system: a clinical and radiographic analysis after a 2-year mean follow-up. Musculoskelet Surg 2012;96 Suppl 1:S69-79.  https://doi.org/10.1007/s12306-012-0198-z
  6. Moon JG, Berglund LJ, Zachary D, An KN, O'Driscoll SW. Radiocapitellar joint stability with bipolar versus monopolar radial head prostheses. J Shoulder Elbow Surg 2009;18:779-84.  https://doi.org/10.1016/j.jse.2009.02.011
  7. Judet T, Garreau de Loubresse C, Piriou P, Charnley G. A floating prosthesis for radial-head fractures. J Bone Joint Surg Br 1996;78:244-9.  https://doi.org/10.1302/0301-620X.78B2.0780244
  8. Brinkman JM, Rahusen FT, de Vos MJ, Eygendaal D. Treatment of sequelae of radial head fractures with a bipolar radial head prosthesis: good outcome after 1-4 years follow-up in 11 patients. Acta Orthop 2005;76:867-72.  https://doi.org/10.1080/17453670510045516
  9. Rovesta C, Minervini C, Bonanno G, Celli L. The radial head prosthesis: historical perspective. In: Celli A, Celli L, Morrey BF, eds. Treatment of elbow lesions. Springer Milan; 2008. p. 137-43. 
  10. Zunkiewicz MR, Clemente JS, Miller MC, Baratz ME, Wysocki RW, Cohen MS. Radial head replacement with a bipolar system: a minimum 2-year follow-up. J Shoulder Elbow Surg 2012;21:98-104.  https://doi.org/10.1016/j.jse.2011.05.012
  11. Moro JK, Werier J, MacDermid JC, Patterson SD, King GJ. Arthroplasty with a metal radial head for unreconstructible fractures of the radial head. JBJS 2001;83:1201. 
  12. Chapman CB, Su BW, Sinicropi SM, Bruno R, Strauch RJ, Rosenwasser MP. Vitallium radial head prosthesis for acute and chronic elbow fractures and fracture-dislocations involving the radial head. J Shoulder Elbow Surg 2006;15:463-73.  https://doi.org/10.1016/j.jse.2005.09.010
  13. Lim YJ, Chan BK. Short-term to medium-term outcomes of cemented Vitallium radial head prostheses after early excision for radial head fractures. J Shoulder Elbow Surg 2008;17:307-12.  https://doi.org/10.1016/j.jse.2007.07.020
  14. Heijink A, Morrey BF, van Riet RP, O'Driscoll SW, Cooney WP. Delayed treatment of elbow pain and dysfunction following Essex-Lopresti injury with metallic radial head replacement: a case series. J Shoulder Elbow Surg 2010;19:929-36.  https://doi.org/10.1016/j.jse.2010.03.007
  15. Katthagen JC, Jensen G, Lill H, Voigt C. Monobloc radial head prostheses in complex elbow injuries: results after primary and secondary implantation. Int Orthop 2013;37:631-9.  https://doi.org/10.1007/s00264-012-1747-7
  16. Sarris IK, Kyrkos MJ, Galanis NN, Papavasiliou KA, Sayegh FE, Kapetanos GA. Radial head replacement with the MoPyC pyrocarbon prosthesis. J Shoulder Elbow Surg 2012;21:1222-8.  https://doi.org/10.1016/j.jse.2011.12.004
  17. El Sallakh S. Radial head replacement for radial head fractures. J Orthop Trauma 2013;27:e137-40.  https://doi.org/10.1097/BOT.0b013e318269b7b7
  18. Ricon FJ, Sanchez P, Lajara F, Galan A, Lozano JA, Guerado E. Result of a pyrocarbon prosthesis after comminuted and unreconstructable radial head fractures. J Shoulder Elbow Surg 2012;21:82-91.  https://doi.org/10.1016/j.jse.2011.01.032
  19. Berschback JC, Lynch TS, Kalainov DM, Wysocki RW, Merk BR, Cohen MS. Clinical and radiographic comparisons of two different radial head implant designs. J Shoulder Elbow Surg 2013;22:1108-20.  https://doi.org/10.1016/j.jse.2013.02.011
  20. Mou Z, Chen M, Xiong Y, Fan Z, Wang A, Wang Z. Comminuted radial head fractures treated by the Acumed anatomic radial head system. Int J Clin Exp Med 2015;8:6327-33. 
  21. Levy JC, Formaini NT, Kurowicki J. Outcomes and radiographic findings of anatomic press-fit radial head arthroplasty. J Shoulder Elbow Surg 2016;25:802-9.  https://doi.org/10.1016/j.jse.2015.11.014
  22. Gauci MO, Winter M, Dumontier C, Bronsard N, Allieu Y. Clinical and radiologic outcomes of pyrocarbon radial head prosthesis: midterm results. J Shoulder Elbow Surg 2016;25:98-104.  https://doi.org/10.1016/j.jse.2015.08.033
  23. Ashwood N, Bain GI, Unni R. Management of Mason type-III radial head fractures with a titanium prosthesis, ligament repair, and early mobilization. J Bone Joint Surg Am 2004;86:274-80.  https://doi.org/10.2106/00004623-200402000-00009
  24. Wretenberg P, Ericson A, Stark A. Radial head prosthesis after fracture of radial head with associated elbow instability. Arch Orthop Trauma Surg 2006;126:145-9.  https://doi.org/10.1007/s00402-005-0032-2
  25. Doornberg JN, Parisien R, van Duijn PJ, Ring D. Radial head arthroplasty with a modular metal spacer to treat acute traumatic elbow instability. J Bone Joint Surg Am 2007;89:1075-80.  https://doi.org/10.2106/00004623-200705000-00021
  26. Chien HY, Chen AC, Huang JW, Cheng CY, Hsu KY. Short- to medium-term outcomes of radial head replacement arthroplasty in posttraumatic unstable elbows: 20 to 70 months follow-up. Chang Gung Med J 2010;33:668-78. 
  27. Muhm M, de Castro R, Winkler H. Radial head arthroplasty with an uncemented modular metallic radial head prosthesis: shortand mid-term results. Eur J Trauma Emerg Surg 2011;37:85-95.  https://doi.org/10.1007/s00068-010-0051-8
  28. Chen X, Wang SC, Cao LH, Yang GQ, Li M, Su JC. Comparison between radial head replacement and open reduction and internal fixation in clinical treatment of unstable, multi-fragmented radial head fractures. Int Orthop 2011;35:1071-6.  https://doi.org/10.1007/s00264-010-1107-4
  29. Watters TS, Garrigues GE, Ring D, Ruch DS. Fixation versus replacement of radial head in terrible triad: is there a difference in elbow stability and prognosis. Clin Orthop Relat Res 2014;472:2128-35.  https://doi.org/10.1007/s11999-013-3331-x
  30. Moghaddam A, Raven TF, Dremel E, Studier-Fischer S, Grutzner PA, Biglari B. Outcome of radial head arthroplasty in comminuted radial head fractures: short and midterm results. Trauma Mon 2016;21:e20201. 
  31. Yan M, Ni J, Song D, Ding M, Liu T, Huang J. Radial head replacement or repair for the terrible triad of the elbow: which procedure is better. ANZ J Surg 2015;85:644-8.  https://doi.org/10.1111/ans.13060
  32. Marsh JP, Grewal R, Faber KJ, Drosdowech DS, Athwal GS, King GJ. Radial head fractures treated with modular metallic radial head replacement: outcomes at a mean follow-up of eight years. J Bone Joint Surg Am 2016;98:527-35.  https://doi.org/10.2106/JBJS.15.00128
  33. Dotzis A, Cochu G, Mabit C, Charissoux JL, Arnaud JP. Comminuted fractures of the radial head treated by the Judet floating radial head prosthesis. J Bone Joint Surg Br 2006;88:760-4.  https://doi.org/10.1302/0301-620X.88B6.17415
  34. Popovic N, Lemaire R, Georis P, Gillet P. Midterm results with a bipolar radial head prosthesis: radiographic evidence of loosening at the bone-cement interface. J Bone Joint Surg Am 2007;89:2469-76.  https://doi.org/10.2106/JBJS.F.00723
  35. Burkhart KJ, Mattyasovszky SG, Runkel M, et al. Mid- to longterm results after bipolar radial head arthroplasty. J Shoulder Elbow Surg 2010;19:965-72.  https://doi.org/10.1016/j.jse.2010.05.022
  36. Celli A, Modena F, Celli L. The acute bipolar radial head replacement for isolated unreconstructable fractures of the radial head. Musculoskelet Surg 2010;94 Suppl 1:S3-9.  https://doi.org/10.1007/s12306-010-0062-y
  37. Allavena C, Delclaux S, Bonnevialle N, Rongieres M, Bonnevialle P, Mansat P. Outcomes of bipolar radial head prosthesis to treat complex radial head fractures in 22 patients with a mean follow-up of 50 months. Orthop Traumatol Surg Res 2014;100:703-9.  https://doi.org/10.1016/j.otsr.2014.06.019
  38. Kodde IF, Heijink A, Kaas L, Mulder PG, van Dijk CN, Eygendaal D. Press-fit bipolar radial head arthroplasty, midterm results. J Shoulder Elbow Surg 2016;25:1235-42.  https://doi.org/10.1016/j.jse.2016.02.007
  39. Viveen J, Kodde IF, Koenraadt KL, Beumer A, The B, Eygendaal D. Clinical and radiographic outcome of revision surgery of radial head prostheses: midterm results in 16 patients. J Shoulder Elbow Surg 2017;26:394-402.  https://doi.org/10.1016/j.jse.2016.09.047
  40. Chanlalit C, Shukla DR, Fitzsimmons JS, An KN, O'Driscoll SW. Effect of hoop stress fracture on micromotion of textured ingrowth stems for radial head replacement. J Shoulder Elbow Surg 2012;21:949-54.  https://doi.org/10.1016/j.jse.2011.05.001
  41. Chanlalit C, Shukla DR, Fitzsimmons JS, An KN, O'Driscoll SW. The biomechanical effect of prosthetic design on radiocapitellar stability in a terrible triad model. J Orthop Trauma 2012;26:539-44.  https://doi.org/10.1097/BOT.0b013e318238b3a2
  42. Chanlalit C, Shukla DR, Fitzsimmons JS, Thoreson AR, An KN, O'Driscoll SW. Radiocapitellar stability: the effect of soft tissue integrity on bipolar versus monopolar radial head prostheses. J Shoulder Elbow Surg 2011;20:219-25.  https://doi.org/10.1016/j.jse.2010.10.033
  43. Sershon RA, Luchetti TJ, Cohen MS, Wysocki RW. Radial head replacement with a bipolar system: an average 10-year follow-up. J Shoulder Elbow Surg 2018;27:e38-44. https://doi.org/10.1016/j.jse.2017.09.015