Related Experiment Videos
Total elbow allografts with collateral ligament reconstruction for posttraumatic elbow injuries
Amirhesam Ehsan1, Brian Lee, John M Itamura
1Department of Orthopaedic Surgery, University of Southern California, 2025 Zonal Avenue, GNH 3900, Los Angeles, CA 90089, USA.
Background:
The use of total osteoarticular elbow allografts as a salvage procedure for reconstruction of posttraumatic elbow periarticular defects and bone loss has been previously described. Although the procedure restores bone stock and provides a painless functional joint, it is associated with multiple complications, including infection, nonunion, and instability.
Methods:
We report a consecutive series of eight patients with posttraumatic elbow injuries and extensive bone loss treated with massive osteoarticular elbow allografts augmented by collateral ligament reconstruction using hamstring allograft. To improve union rates, bone morphogenetic protein-II was applied to the host-graft junctions of the reconstructed elbow. Patients were evaluated clinically and radiographically. The average age of patients was 43 years (range 30-69 years).
Results:
At a mean follow up of 32 months (range 18-44 months), the average Mayo Elbow Performance Score was 81. All patients reported no or only minimal pain in the elbow. The average arc of motion was 102°, and the mean rotational arc of motion was 100°. Four of the eight elbows developed a complication.
Conclusions:
This procedure may serve as a viable salvage option in selected patients with the potential to provide pain relief and improve function, but it is associated with a high complication rate.