Total Elbow Arthroplasty with Massive Composite Allografts

Author(s): Renfree KJ, Dell PC, Kozin SH, et al.

Source: Journal of Shoulder and Elbow Surgery 13(3): 313-321, 2004.

Summary:

This article retrospectively evaluates a mean 6.5 year outcome of massive allograft prosthetic composites in patients with osteoarticular resections of the elbow. This is a retrospective study of 10 patients with a total of 14 procedures. The outcome measures used were the Bryan-Morrey and Hospital for Special Surgery elbow scoring systems.  The results indicate only a modest improvement in pain and stability, but overall a disappointing return of function. It was also significant that multiple procedures were used to optimize the results. Overall, they had an 80% rate of allograft host union.

The results of this article mirror those of hip and knee arthroplasty, with the exception of the poor return of function.  Interestingly, although the mean active flexion/extension of the elbow is 90°, the patients still reportedly had poor return of function with independent self-care possible in only 3 patients.  Overall, it is difficult to evaluate the results of this when compared with the results of composite osteoarticular allografts. This is an operation wrought with complications including heterotopic bone formation, nerve injury, and chronic deep infection.

 

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Journal of Shoulder and Elbow