Elbow Arthroplasty - Cadaveric Allografts

All joint arthroplasties have a limited life span, and will eventually fail. If the patient outlives the prosthesis, revision arthroplasty surgery will be needed. For this reason, arthroplasty may not be appropriate for young patients. Transplantation of cadaveric total elbow allografts [6] have been developed for patients who are not candidates for total elbow replacement surgery. These are usually young patients with disabling elbow joint disease related to post traumatic osteoarthritis, or patients with massive bone loss after trauma, tumor resection, or revision elbow arthroplasty. Cadaveric elbow allografts are viewed as a salvage procedure, and are prone to nonunion and gross instability [7]. Other options include arthrodesis.
 

32 year old woman status post multiple surgeries for elbow fractures, complicated by infection. There has been extensive debridement of the articular surfaces

Baseline study status post cadaveric elbow allograft. Humeral junction (red arrow). Ulnar junction (blue arrow).

Follow up study demonstrates failure of incorporation of bone graft at the humeral junction (red arrow).

 

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