The comparative performance of radial head prostheses in patients younger than and older than 50 years: a systematic review
Background: Patient age may play a role in the surgeon’s decision between radial head arthroplasty (RHA) and open reduction internal fixation in radial head fracture treatment. Though large sample reports have detailed outcomes of radial head replacement for a mean age younger than 50 years, the age...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-02-01
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| Series: | JSES Reviews, Reports, and Techniques |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S266663912200102X |
| _version_ | 1811173265601724416 |
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| author | John J. Heifner, MD, MS Asdrubal E. Rivera Dones, MD A. Laurie Wells, PhD Deana M. Mercer, MD |
| author_facet | John J. Heifner, MD, MS Asdrubal E. Rivera Dones, MD A. Laurie Wells, PhD Deana M. Mercer, MD |
| author_sort | John J. Heifner, MD, MS |
| collection | DOAJ |
| description | Background: Patient age may play a role in the surgeon’s decision between radial head arthroplasty (RHA) and open reduction internal fixation in radial head fracture treatment. Though large sample reports have detailed outcomes of radial head replacement for a mean age younger than 50 years, the age ranges are widely distributed. Patient outcomes are not uniform across a broad age distribution. Therefore, treatment decisions should be evaluated within the confines of a narrower age bracket. An understanding of clinical outcomes for radial head replacement in younger adults will provide value for guiding treatment decisions. We performed a systematic review comparing the clinical outcomes for radial head replacement in patients younger and older than 50 years of age. Further analysis compared outcomes between RHA performed as a primary procedure and as a secondary procedure in patients younger and older than 50 years of age. Methods: PubMed was queried for articles which delineated individual patient data for age, surgical treatment, and appropriate outcome metrics. Articles were grouped based on patient age of under 50 and over 50 years and within those age groups, based on the arthroplasty being performed as a primary or as a secondary procedure. Results: There were no significant differences between the under 50 and the over 50 groups for Mayo Elbow Performance Score (P = .79) and for implant revision/removal (P = .32). In the under 50 group, RHA done as a primary procedure had significantly higher (P = .001) mean Mayo Elbow Performance Score than RHA done as a secondary procedure. In the over 50 group, relative risk was 2.39 (95% confidence interval, 2.12-2.69) for implant revision/removal (P = .11) when comparing primary and secondary procedures. Discussion: At a mean follow-up of 48 months, RHA in patients under the age of 50 years had satisfactory outcomes which were comparable to outcomes in patients over the age of 50 years. Across both age groups, arthroplasty performed as a primary procedure demonstrated superior outcomes compared to arthroplasty performed as a secondary procedure. Our findings provide guidance to surgeons who face a multifaceted decision when encountering younger adult patients with radial head fracture patterns that may not be amenable to fixation. Awareness of the age-specific performance of radial head implants is an important component of the decision for surgical treatment. |
| first_indexed | 2024-04-10T17:43:57Z |
| format | Article |
| id | doaj.art-1a283c7b256d4bb0aa270b151bb71c68 |
| institution | Directory Open Access Journal |
| issn | 2666-6391 |
| language | English |
| last_indexed | 2024-04-10T17:43:57Z |
| publishDate | 2023-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JSES Reviews, Reports, and Techniques |
| spelling | doaj.art-1a283c7b256d4bb0aa270b151bb71c682023-02-03T05:01:24ZengElsevierJSES Reviews, Reports, and Techniques2666-63912023-02-01314955The comparative performance of radial head prostheses in patients younger than and older than 50 years: a systematic reviewJohn J. Heifner, MD, MS0Asdrubal E. Rivera Dones, MD1A. Laurie Wells, PhD2Deana M. Mercer, MD3St George’s University School of Medicine, Great River, NY, USA; Corresponding author: John J. Heifner, MD, MS, 8905 SW 87th Ave, Miami, FL 33176, USA.University of Puerto Rico School of Medicine, San Juan, Puerto RicoDepartment of Orthopaedics and Rehabilitation, University of New Mexico, Albuquerque, NM, USADepartment of Orthopaedics and Rehabilitation, University of New Mexico, Albuquerque, NM, USABackground: Patient age may play a role in the surgeon’s decision between radial head arthroplasty (RHA) and open reduction internal fixation in radial head fracture treatment. Though large sample reports have detailed outcomes of radial head replacement for a mean age younger than 50 years, the age ranges are widely distributed. Patient outcomes are not uniform across a broad age distribution. Therefore, treatment decisions should be evaluated within the confines of a narrower age bracket. An understanding of clinical outcomes for radial head replacement in younger adults will provide value for guiding treatment decisions. We performed a systematic review comparing the clinical outcomes for radial head replacement in patients younger and older than 50 years of age. Further analysis compared outcomes between RHA performed as a primary procedure and as a secondary procedure in patients younger and older than 50 years of age. Methods: PubMed was queried for articles which delineated individual patient data for age, surgical treatment, and appropriate outcome metrics. Articles were grouped based on patient age of under 50 and over 50 years and within those age groups, based on the arthroplasty being performed as a primary or as a secondary procedure. Results: There were no significant differences between the under 50 and the over 50 groups for Mayo Elbow Performance Score (P = .79) and for implant revision/removal (P = .32). In the under 50 group, RHA done as a primary procedure had significantly higher (P = .001) mean Mayo Elbow Performance Score than RHA done as a secondary procedure. In the over 50 group, relative risk was 2.39 (95% confidence interval, 2.12-2.69) for implant revision/removal (P = .11) when comparing primary and secondary procedures. Discussion: At a mean follow-up of 48 months, RHA in patients under the age of 50 years had satisfactory outcomes which were comparable to outcomes in patients over the age of 50 years. Across both age groups, arthroplasty performed as a primary procedure demonstrated superior outcomes compared to arthroplasty performed as a secondary procedure. Our findings provide guidance to surgeons who face a multifaceted decision when encountering younger adult patients with radial head fracture patterns that may not be amenable to fixation. Awareness of the age-specific performance of radial head implants is an important component of the decision for surgical treatment.http://www.sciencedirect.com/science/article/pii/S266663912200102XRadial head arthroplastyRadial head fractureRadial head ORIFRadial head revision |
| spellingShingle | John J. Heifner, MD, MS Asdrubal E. Rivera Dones, MD A. Laurie Wells, PhD Deana M. Mercer, MD The comparative performance of radial head prostheses in patients younger than and older than 50 years: a systematic review JSES Reviews, Reports, and Techniques Radial head arthroplasty Radial head fracture Radial head ORIF Radial head revision |
| title | The comparative performance of radial head prostheses in patients younger than and older than 50 years: a systematic review |
| title_full | The comparative performance of radial head prostheses in patients younger than and older than 50 years: a systematic review |
| title_fullStr | The comparative performance of radial head prostheses in patients younger than and older than 50 years: a systematic review |
| title_full_unstemmed | The comparative performance of radial head prostheses in patients younger than and older than 50 years: a systematic review |
| title_short | The comparative performance of radial head prostheses in patients younger than and older than 50 years: a systematic review |
| title_sort | comparative performance of radial head prostheses in patients younger than and older than 50 years a systematic review |
| topic | Radial head arthroplasty Radial head fracture Radial head ORIF Radial head revision |
| url | http://www.sciencedirect.com/science/article/pii/S266663912200102X |
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