ABSTRACT
We present the results of short- to medium-term follow-up of 10 patients following ulna head replacement. The mean age of patients was 63.2 years (range 48-81 years), with the mean duration of follow-up being 48 months (12-88 months). The indications for the procedure were primary osteoarthritis (n = 3), post-traumatic osteoarthritis (n = 4), failed Darrach's procedure (n = 2) and rheumatoid arthritis (n = 1). Two patients required revision (20%), one for gross aseptic loosening of the stem and another for an initially oversized head. At final follow-up, the satisfactory rate was 90%. The mean VAS score was 2.4 (range 0-8). The average DASH score was 37 (range 0-72.5). Our study suggests that ulna head replacement can give satisfactory forearm function; however, concerns exist regarding bone resorption and tapering around the prosthesis, which may affect the long-term performance of the prosthesis. LEVEL OF EVIDENCE: IV.
ABSTRACT
BACKGROUND: The prevalence of failure among repairs of the rotator cuff is well known, but very few objective data exist regarding either the scale or timing of this complication. The aim of this study was to use a previously validated modified technique of roentgen stereophotogrammetric analysis to monitor the behavior of the rotator cuff after repair to establish at what point failure may occur. MATERIALS AND METHODS: A series of 10 patients had metal beads and wire sutures embedded into the humeral greater tuberosity and supraspinatus tendon, respectively, during open cuff repair procedures. Roentgen stereophotogrammetric analysis imaging of the repaired rotator cuffs was performed at set intervals during the first year after surgery. RESULTS: The mean distance between the tendon and bone markers did not increase significantly between the time of surgery and 3 to 4 weeks. There was then a significant increase of 7.0 mm in the distance between the tendon and bone markers, with the largest increase occurring between 3 to 4 weeks and 12 to 14 weeks after surgery, as well as a further small but significant increase of 1.7 mm between 12 to 14 weeks and 1 year. These results were compared with clinical examination and ultrasound findings. CONCLUSION: Most tendon marker movement was seen during the most intensive period of physiotherapy, in the second and third months after surgery. Significantly more movement was seen in the tendon markers of those patients in whom the repair failed.
