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压配合式桡骨小头假体早期无菌性松动 - 6 例病例系列。

Early aseptic loosening of a press-fit radial head prosthesis - A case series of 6 patients.

机构信息

Centre Hospitalier Universitaire Vaudois, 1011 Lausanne, Switzerland.

Department of Orthopaedic Surgery, McGill University, Montreal, Quebec, Canada.

出版信息

J Int Med Res. 2023 Apr;51(4):3000605221135881. doi: 10.1177/03000605221135881.

DOI:10.1177/03000605221135881
PMID:37082909
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10126620/
Abstract

OBJECTIVE

Radial head arthroplasty (RHA) is the principal treatment option for comminuted radial head (RH) fractures. Here, we present six cases of failed RHA using a modular monopolar press-fit RHA that was subsequently withdrawn from the market because it was associated with a high incidence of loosening.

METHODS

We retrospectively collected data from six patients who had received Radial Head Prothesis System at our centre between July 2015 and June 2016. The average follow-up was 40 months.

RESULTS

Aseptic loosening of the stem affected five (83%) of the six RHA. Four of these were symptomatic and RHA removal was performed. For these patients, the pain subsided and their elbow range of motion (ROM) improved.

CONCLUSION

While the ideal design for an RHA is still debatable, RHA is an efficient treatment option that restores elbow stability and function after a comminuted RH fracture. Importantly, removal of the prosthesis is an effective remedy following RHA associated elbow pain and decreased ROM.

摘要

目的

桡骨头置换术(RHA)是粉碎性桡骨头(RH)骨折的主要治疗选择。在这里,我们报告了使用模块化单极压配合 RHA 进行失败的 RHA 的 6 例病例,该 RHA 随后因松动发生率高而退出市场。

方法

我们回顾性地收集了 2015 年 7 月至 2016 年 6 月期间在我们中心接受桡骨头假体系统治疗的 6 名患者的数据。平均随访时间为 40 个月。

结果

5 例(83%)的 6 例 RHA 出现无菌性松动。其中 4 例有症状,行 RHA 切除。对于这些患者,疼痛减轻,肘部活动范围(ROM)改善。

结论

虽然理想的 RHA 设计仍存在争议,但 RHA 是一种有效的治疗选择,可在粉碎性 RH 骨折后恢复肘部稳定性和功能。重要的是,在 RHA 相关肘部疼痛和 ROM 减少的情况下,假体切除是一种有效的治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/57cc/10126620/234b70457ab1/10.1177_03000605221135881-fig7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/57cc/10126620/50dfcc9a1423/10.1177_03000605221135881-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/57cc/10126620/2c2d2316b396/10.1177_03000605221135881-fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/57cc/10126620/c77e173c4a44/10.1177_03000605221135881-fig3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/57cc/10126620/1245af28dc4c/10.1177_03000605221135881-fig4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/57cc/10126620/652f36f2395c/10.1177_03000605221135881-fig5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/57cc/10126620/60be44bc518f/10.1177_03000605221135881-fig6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/57cc/10126620/234b70457ab1/10.1177_03000605221135881-fig7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/57cc/10126620/50dfcc9a1423/10.1177_03000605221135881-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/57cc/10126620/2c2d2316b396/10.1177_03000605221135881-fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/57cc/10126620/c77e173c4a44/10.1177_03000605221135881-fig3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/57cc/10126620/1245af28dc4c/10.1177_03000605221135881-fig4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/57cc/10126620/652f36f2395c/10.1177_03000605221135881-fig5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/57cc/10126620/60be44bc518f/10.1177_03000605221135881-fig6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/57cc/10126620/234b70457ab1/10.1177_03000605221135881-fig7.jpg

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本文引用的文献

1
Radial Head Replacement for Acute Radial Head Fractures: Outcome and Survival of Three Implant Designs With and Without Cement Fixation.桡骨头置换治疗急性桡骨头骨折:三种假体设计(带或不带骨水泥固定)的结果和生存率。
J Orthop Trauma. 2021 Jun 1;35(6):e202-e208. doi: 10.1097/BOT.0000000000001983.
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Overlengthening of the radial column in radial head replacement: a review of the literature and presentation of a classification system.桡骨头置换术中桡骨柱过长:文献复习及分类系统介绍。
Arch Orthop Trauma Surg. 2021 Sep;141(9):1525-1539. doi: 10.1007/s00402-020-03619-9. Epub 2020 Oct 14.
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Comparison of bipolar and monopolar radial head prostheses in elbow fracture-dislocation.
桡骨头双极和单极假体治疗肘关节骨折脱位的比较。
Orthop Traumatol Surg Res. 2020 Apr;106(2):311-317. doi: 10.1016/j.otsr.2019.10.027. Epub 2020 Mar 12.
4
Why does radial head arthroplasty fail today? A systematic review of recent literature.为何如今桡骨头置换术会失败?近期文献的系统评价
EFORT Open Rev. 2020 Jan 28;4(12):659-667. doi: 10.1302/2058-5241.4.180099. eCollection 2019 Dec.
5
Indications and Clinical Results of Radial Head Replacement: Has Anything Changed?桡骨头置换的适应证和临床结果:有变化吗?
J Orthop Trauma. 2019 Dec;33 Suppl 8:S1-S6. doi: 10.1097/BOT.0000000000001641.
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Role of implants surface modification in osseointegration: A systematic review.种植体表面改性在骨整合中的作用:系统评价。
J Biomed Mater Res A. 2020 Mar;108(3):470-484. doi: 10.1002/jbm.a.36829. Epub 2019 Nov 14.
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Biomechanical behaviours of the bone-implant interface: a review.骨-种植体界面的生物力学行为:综述。
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Interventions for displaced radial head fractures: network meta-analysis of randomized trials.桡骨头骨折移位的干预措施:随机试验的网络荟萃分析。
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Does radial head implant fixation affect functional outcomes? A systematic review and meta-analysis.桡骨头植入物固定是否会影响功能结果?系统评价和荟萃分析。
J Shoulder Elbow Surg. 2019 Jan;28(1):126-130. doi: 10.1016/j.jse.2018.07.032. Epub 2018 Oct 17.
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Osteolysis as it Pertains to Total Hip Arthroplasty.与全髋关节置换术相关的骨质溶解
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