Long-term outcomes of radial head arthroplasty for complex radial head fractures.

PURPOSE: Radial head arthroplasty is widely used for unreconstructable radial head fractures, particularly in complex elbow trauma, yet long-term outcomes remain poorly documented. This study aimed to assess implant survival and clinical outcomes after radial head arthroplasty performed for traumatic fractures. METHODS: This retrospective monocentric study included patients who underwent radial head arthroplasty between 1997 and 2017 with a minimum follow-up of seven years. The primary outcome was implant survival, defined as absence of revision or implant removal. Secondary outcomes included pain (numerical rating scale), range of motion, grip strength, functional scores (MEPS, Broberg-Morrey, QuickDASH), and radiographic findings. RESULTS: Fifty-four patients underwent radial head arthroplasty, and 47 were included in the survival analysis. At a mean follow-up of 142.7 ± 52.5 months, implant survival was 91.5%, with four revisions (8.5%), all within the first postoperative year. Clinical evaluation was available for 28 patients at a mean follow-up of 144.2 ± 56.9 months. Mean pain score was 0.57 ± 1.53, flexion-extension arc 112° ± 18, and grip strength 83.7% of the contralateral side. Mean MEPS was 93.4 ± 12.6, Broberg-Morrey score 82.8 ± 12.9, and QuickDASH 15.4 ± 16.1. Radiographic changes were frequent, including capitellar erosion (60%), heterotopic ossification (60%), and humeroulnar osteoarthritis (55%). CONCLUSION: Radial head arthroplasty provides excellent long-term implant survival with satisfactory functional outcomes. Failures occur early, whereas long-term function remains preserved despite frequent radiographic degenerative changes. LEVEL OF EVIDENCE: IV - retrospective cohort study.