Moro F
Schulter- und Ellenbogenchirurgie, Schulthess Klinik, Lengghalde 2, 8008, Zürich, Schweiz.
Orthopade. 2017 Dec;46(12):1001-1007. doi: 10.1007/s00132-017-3482-7.
There is limited knowledge on composite allograft reconstructions in revision elbow arthroplasty. A major reason for the restricted use of freshly frozen allografts is the divergent legal requirements for allograft procurement in European countries.
The opportunities and limitations of this complex revision surgery of the elbow are outlined based on our own restricted experiences, as well as on current literature. Our experience is in accordance with that of other institutions. The results are heterogeneous and range from satisfying to poor. The main problems are the increased risk of infection and the lack of allograft incorporation. Therefore, salvage procedures such as resection arthroplasty still need to be considered. It is not possible to define universally applicable treatment guidelines due to the limited caseload, even when an acceptable functional outcome can be achieved in the majority of cases. Due to the lack of a "simple solution" or valid guidelines, treatment strategies should be individualized for each patient. Complications such as infection and failed allograft incorporation represent the key issues of this procedure and remain a major challenge in revision surgery.
关于翻修肘关节置换术中复合异体骨重建的知识有限。新鲜冷冻异体骨使用受限的一个主要原因是欧洲各国在异体骨获取方面的法律要求存在差异。
基于我们自身有限的经验以及当前文献，概述了这种复杂的肘关节翻修手术的机遇和局限性。我们的经验与其他机构的经验一致。结果参差不齐，从令人满意到较差不等。主要问题是感染风险增加和异体骨未融合。因此，仍需考虑诸如切除成形术等挽救手术。由于病例数量有限，即使在大多数情况下可以实现可接受的功能结果，也无法制定普遍适用的治疗指南。由于缺乏“简单解决方案”或有效的指南，治疗策略应针对每个患者进行个体化制定。感染和异体骨融合失败等并发症是该手术的关键问题，仍然是翻修手术中的一项重大挑战。
