Radial Head Prosthesis Removal:a Retrospective Case Series of ۱۴ Patients

Background:  The purpose of this study was to report the preoperative complaints and postoperative outcome of patients after removal of the radial head prosthesis.   Methods:  This is a retrospective review of ۱۴ adult patients (۶ females and ۸ males) from ۲۰۰۷ to ۲۰۱۱, who underwent radial head prosthesis removal by three surgeons. The average time between implantation and removal was ۲۳ months (range from ۲ weeks to ۱۲ years, median ۱۲ months).  Results:  The leading reported complaints before removal were restricted mobility of the elbow (active range of motion of less than ۱۰۰ degrees) in ۶, pain in ۳, and pain together with restricted mobility in ۴ patients. The objective  findings before removal were restricted mobility of the elbow in ۱۰ (۷۱%), capitellar cartilage wear, loose implants, and heterotopic ossification each in ۸ (۵۷%), subluxation of the radio-capitellar joint or malpositioning of the stem in ۵ (۳۶%), and chronic infection in ۲ (۱۴%) patients. All patients with pain had wear of the capitellar cartilage on radiographs. The ulnar nerve was decompressed in four patients at the time of removal. Four patients underwent a subsequent operation for postoperative ulnar nerve symptoms ۵ to ۲۱ months after removal. Four patients were still complaining about persistent pain at the last follow-up visit. Except two patients, the total range of motion improved with a mean of ۳۴ degrees (range ۵ to ۷۰) after a mean follow-up of ۱۱ months. Conclusions:  Removal of radial head prosthesis improved function and lessened pain in our case series. The reoperation rate was yet nearly ۳۰% due to ulnar neuritis. Selective ulnar nerve decompression at the time of removal must be evaluated, especially in patients with expected large gain in range of motion after removal.

Keywords:

Prosthesis , Radial head , radial head fracture , Removal