Document Type: RESEARCH PAPER

Authors

1 Orthotrauma Research Center Amsterdam, University of Amsterdam, Amsterdam, the Netherlands; Department of Orthopaedic Surgery, Hand and Upper Extremity Service, Massachusetts General Hospital, Boston, MA, USA

2 Department of Orthopaedic Surgery, Academic Medical Center, Amsterdam, the Netherlands; Department of Orthopaedic Surgery, Upper Limb Unit, Amphia Hospital, Breda, the Netherlands

3 Academic Medical Center, Amsterdam, the Netherlands, Department of Orthopaedic Surgery, Upper Limb Unit, Amphia Hospital, Breda, the Netherlands

4 Department of Orthopaedic Surgery, Shoulder and Elbow Unit, Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands

5 Orthopaedic Surgeon, Department of Orthopaedic Surgery, Upper Limb Unit, Amphia Hospital, Breda, the Netherlands

Abstract

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

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