Total elbow allografts with collateral ligament reconstruction for posttraumatic elbow injuries.
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.
Department of Orthopaedic Surgery, University of Southern California, 2025 Zonal Avenue, GNH 3900, Los Angeles, CA 90089, USA.
Amirhesam
A
Ehsan
Brian
B
Lee
John M
JM
Itamura
D000328:Adult; D000368:Aged; D019643:Arthroplasty, Replacement / Q000379:methods*; D015331:Cohort Studies; D017885:Collateral Ligaments / Q000601:surgery*; D004551:Elbow Joint / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016059:Range of Motion, Articular; D020127:Recovery of Function; D012189:Retrospective Studies; D016896:Treatment Outcome; D000092464:Elbow Injuries