Stem fit design may not impact clinical outcomes of radial head arthroplasty
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Key takeaways:
- Radial head arthroplasty with loose-fit vs. press-fit stems may yield similar revision and reoperation rates.
- Surgeon familiarity, implant availability and cost may be factors to consider when choosing a stem.
Loose-fit and press-fit stems for radial head arthroplasty may yield comparable rates of revision and reoperation, according to published results.
David W. Zeltser, MD, from the department of orthopedic surgery at Washington Permanente Medical Group in Bellevue, Washington, and colleagues performed a multicenter cohort study of 1,575 patients (mean age, 54.2 years) who underwent radial head arthroplasty between 2009 and 2021. Among the cohort, 681 patients received loose-fit stems and 894 patients received press-fit stems.
At 8-year follow-up, Zeltser and colleagues found the cumulative rate of revision was 2.6% for loose-fit stems and 3.5% for press-fit stems, while the cumulative rate of reoperation was 3.8% for loose-fit stems and 4.4% for press-fit stems.
After performing adjusted analysis, Zeltser and colleagues found no differences between loose-fit vs. press-fit stems for incidences of revision (HR = 0.78) or reoperation (HR = 0.73).
They also noted no differences in revisions or reoperations for loose-fit vs. press-fit stems among a subgroup of patients who underwent at least one concomitant procedure on the same extremity at the time of radial head arthroplasty (HR = 0.9).
“The choice between using an implant with a loose- or press-fit stem may be based more on surgeon familiarity, implant availability and cost, and ease of use,” Zeltser and colleagues wrote in the study.
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