Work

Revision of total elbow arthroplasty due to humeral loosening with large bone defect using humeral allograft-prosthesis composite: A case report

Year: 2025

Type: article

Abstract: Revision of total elbow arthroplasty is a challenging procedure, especially when associated with humeral bone deficiency. The purpose of this case report is to highlight the successful management of humeral-sided loosening due to bone defects, using an allograft-prosthesis composite with a humeral bone allograft. A 70-year-old female patient under medication for rheumatoid arthritis underwent revision of left total elbow arthroplasty due to major bone defect and loosening on the humeral side. The allograft-prosthesis composite method was used to address the bone defect and loosening of the humeral side by using humeral allograft as well as plating the host humeral bone. There were no post-operative complications. The radiographic assessment at her latest follow-up was unremarkable, along with a significant improvement on the functional scores and range of motion. The use of a humeral allograft is a valuable option for the management of loosened total elbow arthroplasty with significant bone loss. However, more studies need to be conducted to determine the long-term outcomes of revision surgery of total elbow arthroplasty with humeral bone loss. • Revision of total elbow arthroplasty in RA patients with humeral-sided loosening and severe bone defect remains a major surgical challenge. • Humeral loosening in TEAs is not as common as the ulnar-sided loosening. • A humeral allograft–prosthesis composite (APC) was successfully used to reconstruct the distal humerus. • Compression plate fixation at the host–allograft junction provided stable integration and prevented non-union. • The technique achieved pain-free range of motion and excellent short-term functional outcome without complications. • Humeral allograft APC is a valuable option in selected cases, though long-term outcomes require further investigation.

Source: International Journal of Surgery Case Reports

DOI: 10.1016/j.ijscr.2025.111993

Authors: Eleni Pappa, Tim Cresswell

Institutions: KAT General Hospital of Attica, Royal Derby Hospital

Language: English

Topic: Elbow and Forearm Trauma Treatment

Subfield: Rehabilitation

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,090