Radiographic Predictors for Short-term Functional Outcome after Radial Head Arthroplasty in Patients with Persistent Symptoms after Treatment for Radial Head

Background: Evaluation of the accurate position after radial head arthroplasty remains a challenge for surgeons. Standard radiographs are used to evaluate the position of the implant, however, results regarding radiographic deficiencies on clinical outcome are not consistent. In this retrospective study our main aim was to determine if subtle radiographic deficiencies after radial head arthroplasty can predict functional outcomes measured with the Mayo Elbow Performance Score (MEPS). Methods: A total of 24 patients, that had a press-fit bipolar radial head arthroplasty because of persistent symptoms after treatment of a radial head fracture, were included. The mean follow-up time was 27 months and the MEPS was assessed at the final follow-up. Three upper extremity orthopaedic surgeons evaluated 12 potential deficiencies on anteroposterior and lateral radiographs in consensus agreement. Results: The median MEPS was 97.5 (Interquartile Range 82.5-100). No association was found between the presence of subtle radiographic deficiencies and MEPS. Conclusion: Functional outcome of the elbow after uncemented press-fit bipolar radial head arthroplasty is not associated with subtle radiographic deficiencies. Therefore, surgeons might accept small imperfections on postoperative radiographs.