title: Three-dimensional suitability assessment of three types of osteochondral autograft for ulnar coronoid process reconstruction.
abstract: BACKGROUND
  Osteochondral autografts with use of the olecranon tip, lateral radial head, or proximal radial head have been employed for coronoid process reconstruction. However, it is unclear which autograft is most suitable for coronoid articular configuration. We assessed 3-dimensional articular facet suitability of 3 osteochondral autografts for coronoid process reconstruction.
  
  
  METHODS
  We performed 3-dimensional computed tomography of 20 elbows to compare the articular facet configuration between the coronoid process and the ipsilateral olecranon tip, lateral radial head, and proximal radial head. We measured the area of the proximity region (≤2.0 mm) between the articular facets of the coronoid process and 3 osteochondral autografts, the covering rate defined as the percentage area of the coronoid articular facet occupied by the proximity region, the location of the proximity region center, and the percentage of the removed ulnohumeral articular facet.
  
  
  RESULTS
  The covering rate was significantly higher with an olecranon graft than with radial head grafts. The regional center of a proximal radial head graft was significantly medial compared with that of olecranon and lateral radial head grafts. The olecranon graft used an average of 13.8% of the ulnohumeral articular facet.
  
  
  CONCLUSIONS
  An olecranon graft was most suitable for defects of the coronoid process involving the tip, and a proximal radial head graft was most suitable for defects of the coronoid process involving the anteromedial rim. The use of an olecranon graft for reconstruction of 50% of the height of the coronoid process does not cause concern for gross elbow instability.
authors.affiliation: Department of Orthopedic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan. Electronic address: kataoka@qk9.so-net.ne.jp.
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Kataoka
authors.affiliation: Department of Physical Therapy, Osaka Yukioka College of Health Science, Osaka, Japan.
authors.forename: Hisao
authors.initials: H
authors.lastname: Moritomo
authors.affiliation: Department of Orthopedic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.
authors.forename: Junichi
authors.initials: J
authors.lastname: Miyake
authors.affiliation: Department of Orthopedic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Murase
authors.affiliation: Department of Orthopedic Biomaterial Science, Osaka University Graduate School of Medicine, Osaka, Japan.
authors.forename: Kazuomi
authors.initials: K
authors.lastname: Sugamoto
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D064592:Autografts; D016025:Bone Transplantation; D002356:Cartilage / Q000637:transplantation; D004551:Elbow Joint / Q000000981:diagnostic imaging / Q000601:surgery; D005260:Female; D018460:Fractures, Comminuted / Q000601:surgery*; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D056740:Olecranon Process / Q000637:transplantation; D019651:Plastic Surgery Procedures; D014057:Tomography, X-Ray Computed; D014457:Ulna / Q000000981:diagnostic imaging / Q000601:surgery*; D014458:Ulna Fractures / Q000000981:diagnostic imaging / Q000601:surgery*
keywords: Coronoid process; Diagnostic Study; Level III; olecranon graft; radial head graft; reconstruction; three-dimensional analysis