The Musculoskeletal Tissue Bank represents a very precious aid in shoulder and elbow surgery for the treatment of different complex pathologies, both in traumatology and elective surgery.
In shoulder surgery, bone tissue is used as a filling graft in bone loss due to trauma or congenital conditions. In complex fractures with osteoporosis of the proximal humerus, a deficit of cancellous bone is often present, making it harder to apply fixation devices. In these cases, the support from a wedge-shaped bone graft is extremely useful to add structure and reshape the fractured part anatomically, by stabilising the fixation in the correct position.

At the same time, in the case of pseudoarthrosis of the humeral surgical neck, it is possible to apply a peroneal epiphysis that will stabilise the humeral head lacking cancellous bone, and also the diaphysis, because the bone, in these cases, is extremely weak (see image).
In the diaphysis, the shafts offer an extremely valid help for stability in the case of osteosynthesis or pseudoarthrosis where a lack of bone is present, as well as in hip and knee surgery.

In elbow surgery, often the homologous radial head is used and shaped to recover the deficit of the coronoid process in the ulna. This procedure is a subject of scientific publications, offering a very good solution for an extremely serious issue of the elbow (complex instability with the bone deficit) with very few therapeutic alternatives (see images). 

Furthermore, it is possible to use homologous tendons for ligament reconstructions involving the upper limb. For example, tendons of thin dimensions, such as flexors and extensors of the hallux, are required for the reconstruction of the collateral ligaments of the elbow, in the case of simple chronic instability (the cases in which only soft tissues are involved).