Radiuskopfendoprothetik - Operationstechnik und eigene Ergebnisse

BACKGROUND: Radial head arthroplasty is an established method to restore the anatomy and biomechanics of the elbow joint - especially for non-reconstructable radial head fractures.

AIMS: This video article aims to explain the indications, the surgical procedure and the postoperative rehabilitation protocol for radial head replacement. We also present our own results with this procedure.

MATERIAL AND METHODS: Since 2014, we have prospectively evaluated all patients undergoing surgery for radial head replacement (MoPyC, Tornier, France). A 6 month follow-up of 11 patients is now available. Moreover, 3 retrospective cases with rare complications are reported which were not part of our prospective evaluation.

RESULTS: 8 of 11 procedures were performed due to acute, non-reconstructable radial head fractures. Secondary radial head replacement as a result of failed osteosynthesis was performed in the remaining 3 cases. 8 patients had clinically relevant concomitant injuries to the elbow joint. The mean Mayo Elbow Performance Score was 88 points (65 to 100 points). The arc of motion averaged 124° (± 18°). At 6 months, the mean extension lag was 8°. There were no complications requiring revision surgery at 6 months. Retrospective evaluation found one patient with extensive osteolysis due to oversizing of the shaft, one with disconnection of the prosthesis and one with a broken prosthesis shaft.

CONCLUSIONS: The clinical results with radial head arthroplasty are promising. Accurate implantation is crucial to minimise the risk of complications requiring revision surgery.