Ricón F Javier, Lajara Francisco, Fuentes Alfonso, Aguilar María Luz, Boix Alberto, Lozano Juan A
Orthopaedic and Trauma Surgery Department, Hospital Vega Baja de Orihuela, Calle País Valenciano, 14-B21, 03300, Orihuela, Alicante, Spain.
Orthopaedic and Trauma Surgery Department, Hospital Vega Baja de Orihuela, Plaza de la Purisima, 12, 30640, Abanilla, Murcia, Spain.
J Orthop Traumatol. 2018 Aug 23;19(1):13. doi: 10.1186/s10195-018-0499-6.
The aim of this study is to describe the mid-term radiological findings appearing in patients with a pyrocarbon radial head prosthesis, and to correlate them to patient symptoms.
We review 18 patients who underwent radial head implantation of the MoPyC prosthesis between 2004 and 2015, due to unreconstructible radial head fractures. The clinical outcomes were assessed with Mayo Elbow Performance Score (MEPS). Range of motion, pain, and elbow radiological assessments were recorded. A non-parametric, statistical analysis was carried out to assess the radiological findings with the clinical outcomes.
We have found that after a mean follow-up of 6.5 years (2-11 years), patients have recovered a median flexion arch of 113°, therefore 77% are classed as satisfactory outcomes and the average MEPS score is 89.5. The presence of periprosthetic changes on X-ray is highly frequent-we found radiolucent lines in 38% of cases, radial neck re-absorption in 83%, and arthrosic changes in 78%. However, the differences found when correlating these changes with the clinical results have not been statistically significant (p > 0.05).
Satisfactory outcomes can be expected midterm when using pyrocarbon prostheses in around 75% of the cases. We consider radial neck re-absorption to be a sign of good stem osteointegration, whereas progressive radiolucencies and loss of the ballooning of the stem legs are signs of bad prognosis in our series.
IV retrospective case series.
本研究旨在描述接受热解碳桡骨头假体植入的患者出现的中期影像学表现，并将其与患者症状相关联。
我们回顾了2004年至2015年间因不可重建的桡骨头骨折而接受MoPyC假体桡骨头植入的18例患者。采用梅奥肘关节功能评分（MEPS）评估临床结果。记录活动范围、疼痛情况及肘关节影像学评估结果。进行非参数统计分析以评估影像学表现与临床结果的相关性。
我们发现，平均随访6.5年（2 - 11年）后，患者恢复的中位屈曲角度为113°，因此77%的结果被归类为满意，平均MEPS评分为89.5。X线片上假体周围改变非常常见——我们发现38%的病例出现透亮线，83%出现桡骨颈吸收，78%出现关节改变。然而，将这些改变与临床结果相关联时发现的差异无统计学意义（p > 0.05）。
使用热解碳假体时，约75%的病例中期可预期获得满意结果。我们认为桡骨颈吸收是假体柄良好骨整合的标志，而逐渐出现的透亮线和假体柄腿部膨隆消失在我们的系列研究中是预后不良的标志。
IV级回顾性病例系列研究。
