Impaction Grafting in Revision Total Elbow Arthroplasty for Aseptic Loosening and Bone Loss by Yong Girl Rhee, Nam Su Cho, and Chong Suck Parke JBJS Essent

Impaction Grafting in Revision Total Elbow Arthroplasty for Aseptic Loosening and Bone Loss

by Yong Girl Rhee, Nam Su Cho, and Chong Suck Parke

JBJS Essent Surg TechVolume 3(3):e17

July 10, 2013

©2013 by The Journal of Bone and Joint Surgery, Inc.

Yong Girl Rhee et al. JBJS Essent Surg Tech 2013;3:e17
















Metallosis, hypertrophic synovium, cement, and bone fragments are found.



Metallosis, hypertrophic synovium, cement, and bone fragments should be excised as thoroughly as possible.



Preoperative anteroposterior radiograph showing both the humeral and the ulnar component in a false track formed by cortical ballooning and osseous breakage.



Preoperative lateral radiograph showing both the humeral and the ulnar component in a false track formed by cortical ballooning and osseous breakage.



Preoperative lateral radiograph showing the ulnar component in a false track formed by cortical ballooning.



The guidewire in the false track must pierce through the sclerotic dome and enter into the normal medullary canal under fluoroscopic guidance.



Schema of the passing of the sclerotic dome of cortical ballooning to prevent misplacement of revision stems.



Along the guidewire inserted into the ulnar medullary canal, a cannulated reamer is used to widen the distal part of the ulnar medullary canal under fluoroscopic guidance.



The guidewire and cannulated reamer are used on the humeral side in the same manner as on the ulnar side under fluoroscopic guidance.



Morselized allograft is tightly packed into the area of bone loss.



Illustration demonstrating the correct position of the ulnar stem in the medullary canal, which is confirmed with fluoroscopy.



Intraoperative lateral radiograph demonstrating the correct position of the ulnar stem in the medullary canal, which is confirmed with fluoroscopy.



The humeral stem is inserted into the right position under fluoroscopic guidance.



Documents

Impaction Grafting in Revision Total Elbow Arthroplasty for Aseptic Loosening and Bone Loss by Yong Girl Rhee, Nam Su Cho, and Chong Suck Parke JBJS Essent