Study finds similar outcomes of press-fit vs. loose-fit stems for radial head arthroplasty
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Key takeaways:
- Press-fit vs. loose-fit radial head arthroplasty stems have similar rates of revision and reoperation.
- Implant choice may come down to other factors such as ease of use, availability and surgeon experience.
SCOTTSDALE, Ariz. — Patients who received press-fit vs. loose-fit stems for radial head arthroplasty had similar risks for revision and reoperation at 10-year follow-up.
“Radial head arthroplasty implants can be categorized by stem type, most commonly press-fit vs. loose-fit. These different stem types have proposed advantages and disadvantages,” Ronald A. Navarro, MD, said during his presentation at the American Shoulder and Elbow Surgeons Annual Meeting.
“Press-fit [implants] have potential for anatomic reproduction and loosening at the bone-implant interface, whereas loose-fit [implants] really function as a spacer,” he added.
Navarro and colleagues analyzed 1,575 patients (mean age, 54.2 years) who underwent primary radial head arthroplasty with a press-fit (56.8%) or loose-fit implant (43.2%) from 2009 to 2021. Outcomes included risk for revision and reoperation at an average follow-up of 4.6 years.
At 10 years, the cumulative revision incidence was 3% in the press-fit cohort and 2.1% in the loose-fit cohort. According to the abstract, reasons for revision included stiffness (n = 14), pain (n = 11), instability (n = 9), infection (n = 7) and mechanical dissociation (n = 2). Similarly, cumulative reoperation incidence was 4.6% in the press-fit cohort and 4.1% in the loose-fit cohort.
Researchers found no significant differences in risk for revision (adjusted HR = 0.75) or risk for reoperation (aHR = 0.78) by stem type. They also noted no differences in risk for revision (HR = 0.58) or reoperation (HR = 1.17) in a subgroup analysis of patients who underwent a concomitant procedure in the same extremity at the time of radial head arthroplasty.
“Implant survival was similar between the stem types,” Navarro said.
“Maybe other implant characteristics play a much more important role in the choice of implant: ease of use, availability and surgeon experience,” he concluded.
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Navarro RA, et al. Paper 28. Presented at: American Shoulder and Elbow Surgeons Annual Meeting; Oct. 4-7, 2023; Scottsdale, Ariz.
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