J Korean Orthop Assoc.  2009 Apr;44(2):256-260.

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

• Kim JM
• Koh IJ
• Lee DY

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.

Keyword

Distal humerus; Bone defect; Revisional total elbow arthroplasty; Autogenous iliac bone graft

MeSH Terms

Arthroplasty
Elbow
Incidence
Transplantation, Homologous
Transplants

Figure

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  Fig. 1 The preoperative radiographs of a 42-year old female show components disengagement due to axle pin dislocation with severe bone destruction.

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  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.

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  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.

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  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.

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  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°.

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