ReviewJournal of shoulder and elbow arthroplasty2026
Stem design in radial head arthroplasty: a systematic review and meta-analysis.
Review in Journal of shoulder and elbow arthroplasty, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
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Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Radial head arthroplasty (RHA) is increasingly used for complex elbow instability, yet controversy persists over optimal stem fixation and implant polarity. This study systematically reviews the evidence to determine revision rates, radiographic loosening, and reoperation rates after primary RHA, stratified by stem fixation (intentional loose-fit, press-fit, cemented) and polarity (monopolar vs. bipolar), with specific attention to surveillance time bias. Methods: MEDLINE, Embase, Scopus, and Cochrane databases were searched from inception to October 20, 2025. Studies reporting outcomes of primary RHA with ≥12 months of follow-up and design-specific data were included. Risk of bias was assessed with the Methodological Index for Non-Randomized Studies tool and quality of evidence using Grading of Recommendations Assessment, Development and Evaluation. Both conventional pooled-proportion meta-analysis and incidence-rate (events per 100 patient-years) meta-analysis were performed to adjust for differences in follow-up duration. Results: Forty-six studies (4,467 distinct elbows) were included. In the unadjusted pooled analysis, intentional loose-fit stems demonstrated a lower revision rate (3.4% vs. 8.0%; Conclusion: This large RHA meta-analysis shows the widely reported survival advantage of intentional loose-fit stems may be partly attributable to shorter follow-up in those cohorts. After adjustment for surveillance time, the difference in revision rates between loose-fit and press-fit stems was no longer statistically significant, although the point estimate for press-fit stems remained numerically higher. Implant polarity was not associated with revision risk in any analysis. The additional complexity and cost of bipolar implants may not translate into improved revision-free survival in this dataset.
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