Journal of orthopaedic trauma · 2026
Contemporary Analysis of Revision and Resection Rates in Radial Head Arthroplasty Used in Elbow Trauma.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Goldstein Amelia R, Padon Benjamin, Fong Chloe, Hammond Benjamin, Ganta Abhishek, Konda Sanjit, Egol Kenneth A, Tejwani Nirmal
Аннотация
OBJECTIVE: To evaluate revision and removal rates of radial head arthroplasty (RHA) for elbow trauma using modern press-fit modular implants.
DESIGN: Retrospective cohort study.
SETTING: Urban academic medical center.
PATIENT SELECTION CRITERIA: Patients who underwent RHA (2012-2024) for isolated comminuted radial head fractures, combined head-neck fractures, terrible triad injuries, or Monteggia variants (OTA 2R1) were study eligible. Inclusion criteria consisted of treatment with press-fit modular implants and ≥1 year of clinical follow-up.
OUTCOME MEASURES AND COMPARISONS: Demographics, injury patterns, elbow range of motion, and postoperative complications-including fracture-related infection, nerve injury, periprosthetic fracture, implant resection, and nonresection procedures-were assessed. Implant survivorship was evaluated via Kaplan-Meier analysis.
RESULTS: Two hundred fifty patients were included (mean age 52.2 ± 17.8 years, range 18.1-88.3 years; mean length of follow-up 43.8 ± 35.2 months, range 12.0-128.0 months, body mass index 28.7 ± 6.3 kg/m 2 , 56.8% female). Common indications for RHA included Monteggia fractures (38.0%), isolated radial head fractures (23.6%), and terrible triad injuries (19.2%).Postindex surgery iatrogenic nerve injury occurred in 7.2%, most commonly involving the ulnar nerve. Fracture-related infection occurred in 2.8% postindex surgery, and 1 nonoperative periprosthetic fracture (0.4%) was observed.The resection rate was 7.2% (18/250), with 33.3% (6/18) of implant resection surgeries occurring within 1 year (mean length of follow-up 43.8 ± 35.2 months, range 12.0-128.0 months). Common resection indications included postoperative stiffness (n = 5), infection (n = 4), and neuropathy (n = 3). One-year implant survival was 97.6%, with mean survivorship of 8.5 ± 1.0 years (95% CI, 7.1-9.8).In total, 24 patients (9.6%) underwent additional nonresection procedures including nerve decompressions, elbow contracture releases with excision of heterotopic ossification, and manipulations under anesthesia.At final follow-up (mean 43.8 ± 35.2 months), mean range of motion was 125.4 degrees flexion, -14.9 degrees extension, 73.5 degrees pronation, and 79.3 degrees supination. No significant difference in length of follow-up was observed between patients with postoperative nerve injury (52.4 ± 38.2 months) and those without (42.5 ± 34.8 months, P = 0.16).
CONCLUSION: With a 7.2% resection rate and 1-year implant survival of 97.6%, contemporary press-fit modular RHA demonstrated durable elbow trauma outcomes.
LEVEL OF EVIDENCE: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
DESIGN: Retrospective cohort study.
SETTING: Urban academic medical center.
PATIENT SELECTION CRITERIA: Patients who underwent RHA (2012-2024) for isolated comminuted radial head fractures, combined head-neck fractures, terrible triad injuries, or Monteggia variants (OTA 2R1) were study eligible. Inclusion criteria consisted of treatment with press-fit modular implants and ≥1 year of clinical follow-up.
OUTCOME MEASURES AND COMPARISONS: Demographics, injury patterns, elbow range of motion, and postoperative complications-including fracture-related infection, nerve injury, periprosthetic fracture, implant resection, and nonresection procedures-were assessed. Implant survivorship was evaluated via Kaplan-Meier analysis.
RESULTS: Two hundred fifty patients were included (mean age 52.2 ± 17.8 years, range 18.1-88.3 years; mean length of follow-up 43.8 ± 35.2 months, range 12.0-128.0 months, body mass index 28.7 ± 6.3 kg/m 2 , 56.8% female). Common indications for RHA included Monteggia fractures (38.0%), isolated radial head fractures (23.6%), and terrible triad injuries (19.2%).Postindex surgery iatrogenic nerve injury occurred in 7.2%, most commonly involving the ulnar nerve. Fracture-related infection occurred in 2.8% postindex surgery, and 1 nonoperative periprosthetic fracture (0.4%) was observed.The resection rate was 7.2% (18/250), with 33.3% (6/18) of implant resection surgeries occurring within 1 year (mean length of follow-up 43.8 ± 35.2 months, range 12.0-128.0 months). Common resection indications included postoperative stiffness (n = 5), infection (n = 4), and neuropathy (n = 3). One-year implant survival was 97.6%, with mean survivorship of 8.5 ± 1.0 years (95% CI, 7.1-9.8).In total, 24 patients (9.6%) underwent additional nonresection procedures including nerve decompressions, elbow contracture releases with excision of heterotopic ossification, and manipulations under anesthesia.At final follow-up (mean 43.8 ± 35.2 months), mean range of motion was 125.4 degrees flexion, -14.9 degrees extension, 73.5 degrees pronation, and 79.3 degrees supination. No significant difference in length of follow-up was observed between patients with postoperative nerve injury (52.4 ± 38.2 months) and those without (42.5 ± 34.8 months, P = 0.16).
CONCLUSION: With a 7.2% resection rate and 1-year implant survival of 97.6%, contemporary press-fit modular RHA demonstrated durable elbow trauma outcomes.
LEVEL OF EVIDENCE: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.