Retrospective cohort study on radial head arthroplasty comparing long-term outcomes between valgus type injury and fract
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(2020) 21:763
RESEARCH ARTICLE
Open Access
Retrospective cohort study on radial head arthroplasty comparing long-term outcomes between valgus type injury and fracture dislocation Alvin Chao-Yu Chen* , Chun-Jui Weng, Chih-Hao Chiu, Shih-Sheng Chang, Chun-Ying Cheng and Yi-Sheng Chan
Abstract Background: Radial head arthroplasty (RHA) has been commonly adopted for irreparable radial head fractures while little information is addressed on valgus type injury. The purpose of this study is to report long-term outcomes and radiographic analysis in RHA for valgus type injury with comparison to fracture dislocation injury. Methods: A retrospective cohort study was conducted in patients receiving unilateral RHA with loose-fit, modular metal prosthesis for irreparable radial head fractures between 2004 and 2012. Totally, 33 patients with a mean follow up of 9 years (range, 7 to 15 years) were enrolled and divided into two groups including 14 valgus injuries and 19 fracture-dislocations. Demographics of the patients, injury details, clinical and radiographic outcomes, and correlation analysis were investigated and compared between two groups. Results: In patient demographics, significant difference was noted in sex distribution (p = 0.001), lateral collateral ligament involvement (p = 0.000) and time from injury to RHA (p = 0.031) between two groups. No patient underwent subsequent removal or revision of prosthesis. Good to excellent results according to Mayo Elbow Performance Score (MEPS) was achieved in 13 and 14 patients in group A and B respectively. Final motion range and Disabilities of the Arm, Shoulder, and Hand score was significantly better in valgus injury group. Radiographic analysis demonstrated fewer patients in valgus injury group presented periprosthetic osteolysis with weak to moderate negative correlation between radiolucency score and MEPS. Conclusions: With an average of 9 years follow-up, RHA using loose-fit, modular metal prosthesis achieves encouraging outcomes for both valgus injury and fracture dislocation. In valgus type injury, better motion range, lower disability score and lower incidence of periprosthetic osteolysis is noted while correlation analysis of radiolucency score suggests extended, long-term investigation. Keywords: Radial head arthroplasty (RHA), Loose fit, Valgus injury, Fracture dislocation, Osteolysis, Correlation analysis
* Correspondence: [email protected] Bone and Joint Research Center, Department of Orthopaedic Surgery, Chang Gung Memorial Hospital–Linkou and Chang Gung University College of Medicine, 5th, Fu-Shin Street, Kweishan District, Taoyuan 333, Taiwan, ROC © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party
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