There is a role for allografts in reconstructive surgery of the elbow and forearm

Abstract

Purpose Allografts play an important role in tendon, ligament, and bone reconstruction surgery, particularly when suitable available autologous tissue is limited. Enthusiasm for the use of allografts in reconstructive orthopedic surgery has increased over the past decade, with an increase in allograft use in a variety of procedures. The purpose of this review is to provide an overview of the various applications and indications for the use of allografts in reconstructive surgical procedures of the elbow and forearm. Methods MEDLINE/PubMed was searched from 1990 through October 2018 for studies on tendon and bony allografts in elbow and forearm reconstructive surgery. ResultsThe Achilles tendon allograft is the most frequently used tendinous allograft, predominantly used in distal biceps and triceps reconstruction. Although reconstruction of the ulnar collateral ligament of the elbow is generally performed using autografts, it has been shown that semitendinosus and gracilis allografts may be equally effective. Extensor hallucis longus allografts are recommended for reconstruction of the lateral collateral ligaments in patients with posterolateral rotatory instability, and there may be a role for osteochondral allograft transplantation in capitellar osteochondral defects. In addition, the use of allografts in reconstruction of the interosseous membrane and various bone pathologies (fractures, bone tumors, forearm nonunions) has been described in current literature. Conclusion There is a large variety of pathology and procedures involving the use of various types of allografts in orthopedic reconstructive surgery of the elbow and forearm.

Elbow sarcoma resection and triceps reconstruction with Achilles allograft: an overview, case report, and technique guide

“…Molenaars et al completed a systematic review which highlighted the role of allografts and the propensity to use Achilles tendon allografts in reconstructive surgery involving the elbow. 12 However, it is not without associated risks, including infectious disease transmission, host rejection, and increased cost. 13 , 17 Bennett and Mehlhoff described a technique for triceps reconstruction with Achilles tendon allograft to augment and bridge the triceps tendon.…”

“… 2 Case reports have presented alternatives including, autologous semitendinosus, gracillis allograft, and fascia lata grafts. 3 , 7 , 12 , 20 , 21 While these studies have presented alternatives, no study has compared the biomechanical differences specifically in the setting of triceps grafts. In 2010, Petre et al studied the biomechanical properties of an intact triceps tendon and showed a load to failure (LTF) of 1741.1 N (1705.3-1777.5) and liner stiffness (LS) of 83.7 (71.5-96.0), with directly repaired tendons LTF of 317.4 N (304.1-330.7) LS 12.8 (11.5-14.1) and augmented repairs LTF of 593.1 N (573.7-612.6) and LS 24.9 (22.1-27.8).…”

Subtrochanteric femoral fracture with postoperative chronic osteomyelitis treated successfully by 1-stage operation: a case report

“…Second, repair of the bone defect. Conventional treatments for bone defects generally include transplantation of the fibular segment without a blood supply, inlay bone grafting of cancellous bone, autologous bone marrow transplantation, Ilizarov technique ( 9), bony fusion, or allograft bone transplantation (10,11). However, these methods share 1 defect: the bone graft lacks a blood supply.…”

Rabbit umbilical cord mesenchymal stem cells: A new option for tissue engineering

“…Tissue defects caused by a variety of injuries, such as trauma, tumor and birth defects, can severely impair patients' daily and social lives. Traditionally, autografts and allografts are good choices for repair of tissue defects; however, both have serious issues, including a limited tissue supply and extra surgical trauma 1,2 . Although artificial material implantation can be an alternative approach, it has unexpected drawbacks, such as immune rejection and inadequate mechanical properties 3,4 .…”