gms | German Medical Science

Objectives/Interrogation: To report clinical and radiographic outcomes for the Herbert Ulnar head prosthesis.

Methods: We reviewed all Herbert ulnar head arthroplasties performed at our department between March 2000 and September 2017. Fifty-one arthroplasties were performed in 50 patients. 47 cases had a minimum follow-up of one year. Five patients were lost to follow-up; two deceased unrelated to the operation, one due to unrelated illness and two implants were revised. The 42 remaining implants had a mean follow-up of 6,5 years (range 1-17 years). The rationale for the procedure were; Rheumatoid arthritis (n=12), Osteoarthritis (10), secondary Osteoarthritis (11), painful instability after previous resection arthroplasty (8) and failed implant arthroplasty (1). Assessment included Disability of the Arm, Shoulder and Hand (DASH) and Patient Rated Wrist Evaluation (PRWE) questionnaires, 100 mm Visual analogue scales (VAS) for pain and satisfaction, measurements of range of motion, grip-, lifting- and forearm rotational strength. For 17 of the cases full preoperative assessments, including strength measurements were available. The change in preoperative and last follow-up measurements for these patients was analyzed with Wilcoxon sign rank test.

Results and Conclusions: Data for patient reported outcomes and strength measurements at final follow-up visits are summarized in Table 1 [Tab. 1].

For the subgroup with full preoperative assessment there were significant improvements in DASH, PRWE, VAS for pain with activity and strength for grip and lifting with neutral forearm rotation. We did not detect radiographic signs of implant loosening except for one patient whose implant was revised. Another patient had the implant removed due to recalcitrant pain and one patient underwent successful secondary surgery due to persistent painful DRUJ instability.

In a selected group of patients the Herbert implant produced favorable outcome with a low complication rate.