OKOJ, Volume 8, No. 11

Advances in biomaterials have been central to improvements in orthopaedic implants in all fields of orthopaedics. For the clinician, patient care decisions are most enhanced by key principles and facts, as opposed to technical details. In part I of this series, we review the basic principles of mechanics and corrosion most relevant to biomaterials and implants. Emphasis is given to clinical relevance for patient care decisions.

Osteoarticular allograft transplantation is a biologic reconstruction option for repair of large osseous defects after resection of bone tumors. The functional longevity of this type of reconstruction is a major concern, especially in young, active patients. These demanding reconstructions require time, an experienced group of orthopaedic surgeons working at an institution with access to a large volume of patients, and a reliable, modern bone bank in which grafts are preserved and processed under safe conditions. In this article, we describe current indications and techniques for osteoarticular allograft transplantation and discuss the outcomes of reconstructions performed at our institution. Improvements in anatomic matching, infection prevention, allograft fixation, soft-tissue reconstruction, and rehabilitation protocols have greatly influenced the predictability and longevity of osteoarticular allografts.

Physical examination of the elbow joint should progress in a systematic manner from inspection to palpation, assessment of motion, strength and resistive testing, and evaluation for instability.Findings should be compared with the contralateral side, and a global limb assessment should be performed to rule out overlapping or contributing pathologies. A thorough physical examination of the elbow, in combination with a detailed history of the patient's specific elbow symptoms, is essential for the accurate diagnosis and treatment of elbow disorders.