Abstract
Between 1993 and 2002 7 allografts/joint replacement combinations have been used to treat massive bone loss at the elbow.
The original 4 procedures (2 humeral and 2 ulna allografts) used a standard Stanmore total elbow replacement. Of these the 2 humeral allografts failed and revision surgery was necessary. The 2 grafts on the ulna side of the joint remain in situ (average 6 years after surgery) with one of the patients subsequently having a primary joint replacement on the contra-lateral side.
More recently a further humeral and a further ulna allograft/joint replacement have been performed together with one patient having humeral and ulna allografts on both sides of the joint for extensive bone loss. In these cases the Coonrad-Morrey total elbow arthroplasty was used as the joint implant.
The philosophy behind the use of allografts is discussed and the management principles outlined. The possible reasons for failure of the early humerus allograft/joint replacement combinations is addressed and future developments considered.
The abstracts were prepared by David Stanley. Correspondence should be addressed to him c/o British Orthopaedic Association, Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PN.
