van Riet R P, Sanchez-Sotelo J, Morrey B F
Monica Hospital SPM Deurne, Stevenslei 20, 2100 Deurne, Belgium.
J Bone Joint Surg Br. 2010 May;92(5):661-7. doi: 10.1302/0301-620X.92B5.23067.
There is little information available at present regarding the mechanisms of failure of modern metallic radial head implants. Between 1998 and 2008, 44 consecutive patients (47 elbows) underwent removal of a failed metallic radial head replacement. In 13 patients (13 elbows) the initial operation had been undertaken within one week of a fracture of the radial head, at one to six weeks in seven patients (seven elbows) and more than six weeks (mean of 2.5 years (2 to 65 months)) in 22 patients (25 elbows). In the remaining two elbows the replacement was inserted for non-traumatic reasons. The most common indication for further surgery was painful loosening (31 elbows). Revision was undertaken for stiffness in 18 elbows, instability in nine, and deep infection in two. There were signs of over-lengthening of the radius in 11 elbows. Degenerative changes were found in all but one. Only three loose implants had been fixed with cement. Instability was not identified in any of the bipolar implants.
目前关于现代金属桡骨头植入物失败机制的信息很少。1998年至2008年期间，连续44例患者（47个肘关节）接受了失败的金属桡骨头置换物取出术。13例患者（13个肘关节）的初次手术在桡骨头骨折后一周内进行，7例患者（7个肘关节）在骨折后1至6周进行，22例患者（25个肘关节）在骨折后超过6周（平均2.5年（2至65个月））进行。其余两个肘关节的置换是由于非创伤性原因进行的。进一步手术的最常见指征是疼痛性松动（31个肘关节）。因僵硬进行翻修的有18个肘关节，因不稳定进行翻修的有9个，因深部感染进行翻修的有2个。11个肘关节有桡骨过度延长的迹象。除1例之外，所有病例均发现有退行性改变。只有3个松动的植入物用骨水泥固定。在任何双极植入物中均未发现不稳定情况。
