Dean G S, Holliger E H, Urbaniak J R
Division of Orthopaedic Surgery, Duke University Medical Center, Durham, NC 27710, USA.
Clin Orthop Relat Res. 1997 Aug(341):12-22.
Transplantation of total elbow allografts has been used as a salvage procedure in an attempt to provide patients with functional, painless range of motion of the elbow. This procedure is appropriate for patients with massive bone loss after trauma, tumor resection, or revision elbow arthroplasty. During the past 20 years, 23 patients have undergone elbow allograft reconstruction with variable results and a high complication rate. Ten of 14 patients with elbow allografts observed for an average of 7.5 years report satisfactory results. Allograft removal was required in six patients: for infection (two), instability (three), and nonunion and resorption (one). Three patients with instability have since undergone successful total elbow arthroplasty. Two patients have been observed less than 1 year and another patient died during the study period. Complications occurred in 16 of 23 patients. This operation is not recommended for routine use and is viewed as a salvage procedure. The use of allografts in elbow reconstruction does not preclude subsequent reconstruction with another allograft or fusion. In patients with deficient bone stock, the allograft reestablishes bone mass to permit an arthrodesis or reconstructive arthroplasty.
全肘关节同种异体移植已被用作一种挽救性手术，旨在为患者提供功能性、无痛的肘关节活动范围。该手术适用于创伤、肿瘤切除或肘关节翻修术后出现大量骨质流失的患者。在过去20年中，23例患者接受了肘关节同种异体移植重建，结果各异且并发症发生率较高。14例接受肘关节同种异体移植的患者中，平均随访7.5年，10例报告结果满意。6例患者需要取出同种异体移植物：2例因感染，3例因不稳定，1例因骨不连和吸收。3例不稳定患者随后成功接受了全肘关节置换术。2例患者观察时间不足1年，另1例患者在研究期间死亡。23例患者中有16例出现并发症。该手术不建议常规使用，应视为一种挽救性手术。在肘关节重建中使用同种异体移植物并不排除随后用另一种同种异体移植物进行重建或融合。对于骨量不足的患者，同种异体移植物可重建骨量，以便进行关节融合术或重建性关节成形术。
