Jonelle Marie Petscavage MD, MPH, Presenter: Nothing to Disclose

Alice S. Ha MD, Abstract Co-Author: Nothing to Disclose

Felix Sze-Kway Chew MD, Abstract Co-Author: Nothing to Disclose

Radial head arthroplasty is increasing in popularity for treatment of trauma or arthritis. Most long-term outcome studies of this procedure detail the clinical and orthopedic findings. Our aim was to describe the short and long-term radiographic features of radial head replacements, determine the most common types of complications, and assess for risk factors associated with complications.

This retrospective study had IRB approval. Medical records were searched over a 10-year period for patients who received radial head implants and had follow-up radiographs. All available radiographs were reviewed and correlated with contemporaneous clinical information. Statistical analysis included calculation of complication rate, logistic regression for variable association with complication, and Kaplan Meier survival analysis.

A total of 265 radial head implants were found, 252 of which had at least 2 post-operative imaging studies. 56.7% of implants had at least 6 months of follow-up imaging (range 1-92 months). Arthroplasty design was unipolar in 84.9%, bipolar in 13.5%, and judet in 1.59%. Indications for arthroplasty included radial head fracture in 87.7%, failed radial head arthroplasty in 6%, and failed plate, screw, or resection treatment in 4.8%. Complications included heterotopic bone (56.7%), loosening or bone resorption (20.6%), radial-capitellar osteoarthritis (28.1%), capitellar osteopenia or erosion (31.3%), abnormal tilt (6%), periprosthetic fracture (4%), and disengagement of bipolar components (8.8%). 26 of 252 (10.3%) required surgical removal.

After radial head arthroplasty, complications found on radiographs are common. Our results also provide a timeline of mean time of presentation of the more common complications.

This study will help radiologists recognize normal short and long term appearances of radial head arthroplasty and associated complications.

Petscavage, J, Ha, A, Chew, F, Radial Head Replacement: A Radiographic Outcome Study.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9009620.html