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Impaction Allograft Bone-Grafting for Revision Total Elbow Arthroplasty. A Case Report*
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Investigation performed at the Division of Orthopedic Surgery, University of Alabama at Birmingham, Birmingham
J Bone Joint Surg Am, 1999 Jul 01;81(7):1008-12
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A failed total elbow arthroplasty associated with extensive bone resorption as well as cortical expansion and thinning is a difficult reconstructive problem. Treatment methods such as elbow arthrodesis, interposition arthroplasty, and resection arthroplasty either result in a grossly unstable elbow or are technically difficult to perform5,14-16. When a failed elbow arthroplasty is associated with a limited area of bone loss, a standard long-stem semiconstrained implant can bypass the area of bone deficiency2,4,9,11,14,16. However, the bone deficiency may be so extensive that it is not possible to bypass the area of bone loss with a standard stem. If a standard-length implant is used in the presence of extensive bone loss, severe shortening of the extremity may result. Additionally, the proximal tip of the humeral implant would be placed in close proximity to the humeral head, which could, in the future, preclude the use of a shoulder prosthesis, if needed. Therefore, in instances of major bone loss, custom elbow implants, massive allografts, or implant-allograft composites may be necessary1-6,9,10,13,15,16,21.
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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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