A Novel Autogenous Iliac Bone Graft Technique for Distal Humeral Bone Loss in Revisional Total Elbow Arthroplasty - A Technical Note -

Jung-Man Kim; In-Jun Koh; Dong-Yeob Lee

doi:10.4055/jkoa.2009.44.2.256

Journal List > J Korean Orthop Assoc > v.44(2) > 1012897

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Kim, Koh, and Lee: A Novel Autogenous Iliac Bone Graft Technique for Distal Humeral Bone Loss in Revisional Total Elbow Arthroplasty - A Technical Note -

Technical Note

Journal of the Korean Orthopaedic Association

Journal of the Korean Orthopaedic Association 2009; 44(2): 256-260.

Published online: 30 April 2009

DOI: https://doi.org/10.4055/jkoa.2009.44.2.256

A Novel Autogenous Iliac Bone Graft Technique for Distal Humeral Bone Loss in Revisional Total Elbow Arthroplasty - A Technical Note -

Jung-Man Kim, M.D., In-Jun Koh, M.D., Dong-Yeob Lee, M.D.

Department of Orthopaedic Surgery, Kangnam St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea.

Address reprint requests to In-Jun Koh, M.D. Department of Orthopaedic Surgery, Kangnam St. Mary's Hospital, The Catholic University of Korea College of Medicine, 505, Banpo-dong, Seocho-gu, Seoul 137-701, Korea. Tel: +82.2-590-1464, Fax: +82.2-535-9834, hinman74@naver.com

Abstract

As the incidence of total elbow arthroplasty has increased, revisions of the procedure also increase including reconstruction of bony defects caused by bone destruction. Reconstruction techniques depend on location and severity of the bony defect, and allografts are useful in cases of substantial bone loss. However, this procedure is technically difficult and has a high complication rate. Here, we describe a novel autogenous bone graft technique using tricortical iliac bone for reconstruction of a distal bone loss in a revisional total elbow arthroplasty, providing an additional method to restore bone stock.

Keywords: Distal humerus, Bone defect, Revisional total elbow arthroplasty, Autogenous iliac bone graft

Figures and Tables

Fig. 1

The preoperative radiographs of a 42-year old female show components disengagement due to axle pin dislocation with severe bone destruction.

Fig. 2

An autogenous tricortical iliac bone graft was harvested as much as bone loss in distal humerus. Then it was inserted into humeral stem.

Fig. 3

(A) Intraoperative photograph shows severe bone loss after removal of prosthesis. (B) The final reconstruction of the distal humerus using tricortical iliac bone.

Fig. 4

The postoperative radiographs show the final reconstruction of distal humerus using autogenous tricortical iliac bone graft. The size of harvested autogenous tricortical iliac bone graft was 3.5×1.5 cm.

Fig. 5

The radiographs of 6 months after revision show well maintenance of autogenous tricortical iliac bone graft-prosthesis composite without loosening and progression of union. On last visit, her Mayo elbow performance score improved 30 points preoperatively to 80 points postoperatively and final elbow ROM was 5° to 130°.

References

1. Cheung EV, Adams RA, Morrey BF. Reimplantation of a total elbow prosthesis following resection arthroplasty for infection. J Bone Joint Surg Am. 2008. 90:589–594.

2. Cil A, Veillette CJ, Sanchez-Sotelo J, Morrey BF. Linked elbow replacement: a salvage procedure for distal humeral nonunion. J Bone Joint Surg Am. 2008. 90:1939–1950.

3. Goldberg SH, Omid R, Nassr AN, Beck R, Cohen MS. Osseous anatomy of the distal humerus and proximal ulna: implications for total elbow arthroplasty. J Shoulder Elbow Surg. 2007. 16:Suppl 3. S39–S46.

4. Gschwend N, Scheier NH, Baehler AR. Long-term results of the GSB III elbow arthroplasty. J Bone Joint Surg Br. 1999. 81:1005–1012.

5. Kamineni S, Morrey BF. Distal humeral fractures treated with noncustom total elbow replacement. Surgical technique. J Bone Joint Surg Am. 2005. 87:Suppl 1. S41–S50.

6. Mansat P, Adams RA, Morrey BF. Allograft-prosthesis composite for revision of catastrophic failure of total elbow arthroplasty. J Bone Joint Surg Am. 2004. 86:724–735.

7. Morrey BF, Adams RA. Semiconstrained arthroplasty for the treatment of rheumatoid arthritis of the elbow. J Bone Joint Surg Am. 1992. 74:479–490.

8. Morrey BF, Bryan RS. Revision total elbow arthroplasty. J Bone Joint Surg Am. 1987. 69:523–532.

9. Ramsey ML, Adams RA, Morrey BF. Instability of the elbow treated with semiconstrained total elbow arthroplasty. J Bone Joint Surg Am. 1999. 81:38–47.

10. Sanchez-Sotelo J, O'Driscoll S, Morrey BF. Periprosthetic humeral fractures after total elbow arthroplasty: treatment with implant revision and strut allograft augmentation. J Bone Joint Surg Am. 2002. 84:1642–1650.

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