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

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Presentation transcript:

by Yong Girl Rhee, Nam Su Cho, and Chong Suck Parke 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 Tech Volume 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 ©2013 by The Journal of Bone and Joint Surgery, Inc.

Yong Girl Rhee et al. JBJS Essent Surg Tech 2013;3:e17 ©2013 by The Journal of Bone and Joint Surgery, Inc.

Yong Girl Rhee et al. JBJS Essent Surg Tech 2013;3:e17 ©2013 by The Journal of Bone and Joint Surgery, Inc.

Yong Girl Rhee et al. JBJS Essent Surg Tech 2013;3:e17 ©2013 by The Journal of Bone and Joint Surgery, Inc.

Yong Girl Rhee et al. JBJS Essent Surg Tech 2013;3:e17 ©2013 by The Journal of Bone and Joint Surgery, Inc.

Yong Girl Rhee et al. JBJS Essent Surg Tech 2013;3:e17 ©2013 by The Journal of Bone and Joint Surgery, Inc.

Yong Girl Rhee et al. JBJS Essent Surg Tech 2013;3:e17 ©2013 by The Journal of Bone and Joint Surgery, Inc.

Yong Girl Rhee et al. JBJS Essent Surg Tech 2013;3:e17 ©2013 by The Journal of Bone and Joint Surgery, Inc.

Metallosis, hypertrophic synovium, cement, and bone fragments are found. Yong Girl Rhee et al. JBJS Essent Surg Tech 2013;3:e17 ©2013 by The Journal of Bone and Joint Surgery, Inc.

Metallosis, hypertrophic synovium, cement, and bone fragments should be excised as thoroughly as possible. Metallosis, hypertrophic synovium, cement, and bone fragments should be excised as thoroughly as possible. Yong Girl Rhee et al. JBJS Essent Surg Tech 2013;3:e17 ©2013 by The Journal of Bone and Joint Surgery, Inc.

Preoperative anteroposterior radiograph showing both the humeral and the ulnar component in a false track formed by cortical ballooning and osseous breakage. Preoperative anteroposterior radiograph showing both the humeral and the ulnar component in a false track formed by cortical ballooning and osseous breakage. The arrows indicate the sclerotic dome. Yong Girl Rhee et al. JBJS Essent Surg Tech 2013;3:e17 ©2013 by The Journal of Bone and Joint Surgery, Inc.

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 both the humeral and the ulnar component in a false track formed by cortical ballooning and osseous breakage. The arrows indicate the sclerotic dome. Yong Girl Rhee et al. JBJS Essent Surg Tech 2013;3:e17 ©2013 by The Journal of Bone and Joint Surgery, Inc.

Preoperative lateral radiograph showing the ulnar component in a false track formed by cortical ballooning. Preoperative lateral radiograph showing the ulnar component in a false track formed by cortical ballooning. Yong Girl Rhee et al. JBJS Essent Surg Tech 2013;3:e17 ©2013 by The Journal of Bone and Joint Surgery, Inc.

The guidewire in the false track must pierce through the sclerotic dome and enter into the normal medullary canal under fluoroscopic guidance. The guidewire in the false track must pierce through the sclerotic dome and enter into the normal medullary canal under fluoroscopic guidance. Yong Girl Rhee et al. JBJS Essent Surg Tech 2013;3:e17 ©2013 by The Journal of Bone and Joint Surgery, Inc.

Schema of the passing of the sclerotic dome of cortical ballooning to prevent misplacement of revision stems. Schema of the passing of the sclerotic dome of cortical ballooning to prevent misplacement of revision stems. Yong Girl Rhee et al. JBJS Essent Surg Tech 2013;3:e17 ©2013 by The Journal of Bone and Joint Surgery, Inc.

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. 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. Yong Girl Rhee et al. JBJS Essent Surg Tech 2013;3:e17 ©2013 by The Journal of Bone and Joint Surgery, Inc.

The guidewire and cannulated reamer are used on the humeral side in the same manner as on the ulnar side 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. Yong Girl Rhee et al. JBJS Essent Surg Tech 2013;3:e17 ©2013 by The Journal of Bone and Joint Surgery, Inc.

Morselized allograft is tightly packed into the area of bone loss. Yong Girl Rhee et al. JBJS Essent Surg Tech 2013;3:e17 ©2013 by The Journal of Bone and Joint Surgery, Inc.

Illustration demonstrating the correct position of the ulnar stem in the medullary canal, which is confirmed with fluoroscopy. Illustration demonstrating the correct position of the ulnar stem in the medullary canal, which is confirmed with fluoroscopy. Yong Girl Rhee et al. JBJS Essent Surg Tech 2013;3:e17 ©2013 by The Journal of Bone and Joint Surgery, Inc.

Intraoperative lateral radiograph 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. Yong Girl Rhee et al. JBJS Essent Surg Tech 2013;3:e17 ©2013 by The Journal of Bone and Joint Surgery, Inc.

The humeral stem is inserted into the right position under fluoroscopic guidance. Yong Girl Rhee et al. JBJS Essent Surg Tech 2013;3:e17 ©2013 by The Journal of Bone and Joint Surgery, Inc.