Aims In patients with a failed radial head arthroplasty (RHA), simple removal of the implant is an option. However, there is little information in the literature about the outcome of this procedure. The aim of this study was to review the mid-term clinical and radiological results, and the rate of complications and removal of the implant, in patients whose initial RHA was undertaken acutely for trauma involving the elbow. Methods A total of 11 patients in whom removal of a RHA without reimplantation was undertaken as a revision procedure were reviewed at a mean follow-up of 8.4 years (6 to 11). The range of motion (ROM) and stability of the elbow were recorded. Pain was assessed using a visual analogue scale (VAS). The functional outcome was assessed using the Mayo Elbow Performance Score (MEPS), the Oxford Elbow Score (OES), and the Disabilities of the Arm, Shoulder and Hand questionnaire (DASH). Radiological examination included the assessment of heterotopic ossification (HO), implant loosening, capitellar erosion, overlengthening, and osteoarthritis. Complications and the rate of further surgery were also recorded. Results The indications for removal of the implant were stiffness in five patients, aseptic loosening in five, and pain attributed to the RHA in three. The mean time interval between RHA for trauma to removal was ten months (7 to 21). Preoperatively, three patients had overlengthening of the implant, three had capitellar erosion, six had HO, and four had radiological evidence of loosening. At the final follow-up, the mean the flexion-extension arc improved significantly by 38.2° (95% CI 20 to 59; p = 0.002) and the mean arc of prono-supination improved significantly by 20° (95% CI 0 to 72.5; p = 0.035). The mean pain VAS score improved significantly by 3.5 (95% CI 2 to 5.5; p = 0.004). The mean MEPS improved significantly by 27.5 (95% CI 17.5 to 42.5; p = 0.002). The mean OES improved significantly by 9 (95% CI 2.5 to 14; p = 0.012), and the mean DASH score improved significantly by 23.5 (95% CI 7.5 to 31.6; p = 0.012). Ten patients (91%) had HO and osteoarthritis. Two patients underwent further surgery due to stiffness and pain, respectively. Conclusion Simple removal of the implant at revision surgery following a failed RHA introduced following trauma provides satisfactory mid-term results with an acceptable risk of complications. Osteoarthritis, instability, and radioulnar impingement were not problems in this series.

中文翻译：

---

通过移除植入物治疗失败的桡骨头关节置换术。


目的 对于桡骨头关节置换术 （RHA） 失败的患者，只需简单地移除植入物即可。然而，文献中关于该手术结果的信息很少。本研究的目的是回顾初始 RHA 因累及肘部外伤而急性接受的患者的中期临床和放射学结果，以及并发症和植入物移除的发生率。方法 共有 11 例患者在平均随访 8.4 年 （6 至 11 岁） 时回顾了 RHA 切除而不再植入的翻修手术。记录肘部的运动范围 （ROM） 和稳定性。使用视觉模拟量表 （VAS） 评估疼痛。使用 Mayo Elbow Performance Score （MEPS） 、 Oxford Elbow Score （OES） 和手臂、肩部和手部残疾问卷 （DASH） 评估功能结局。放射学检查包括异位骨化 （HO） 、植入物松动、肱骨侵蚀、超长和骨关节炎的评估。还记录了并发症和进一步手术的发生率。结果 移除植入物的适应症是 5 例患者僵硬，5 例无菌性松动，3 例归因于 RHA 的疼痛。RHA 创伤与切除之间的平均时间间隔为 10 个月 （7 至 21）。术前，3 例患者植入物过长，3 例肱骨糜烂，6 例 HO，4 例有松动的放射学证据。在最后一次随访中，屈伸弧的平均改善了 38.2°（95% CI 20 至 59;p = 0.002），旋后平均弧度显著改善了 20°（95% CI 0 至 72.5;p = 0.035）。平均疼痛 VAS 评分显着提高 3 分。5 （95% CI 2 至 5.5;p = 0.004）。平均 MEPS 显著改善了 27.5 （95% CI 17.5 至 42.5;p = 0.002）。平均 OES 显著改善 9 分（95% CI 2.5 至 14;p = 0.012），平均 DASH 评分显著改善 23.5 分（95% CI 7.5 至 31.6;p = 0.012）。10 例患者 （91%） 患有 HO 和骨关节炎。2 例患者分别因僵硬和疼痛接受了进一步手术。结论 创伤后引入 RHA 失败后，在翻修手术中简单地移除植入物可提供令人满意的中期结果和可接受的并发症风险。骨关节炎、不稳定和桡尺撞击不是该系列的问题。