Comparison of reconstructive techniques following oncologic intraarticular resection of proximal humerus.
J Surg Oncol
; 123(1): 133-140, 2021 Jan.
Article
en En
| MEDLINE
| ID: mdl-33095924
ABSTRACT
INTRODUCTION:
The proximal humerus is a common site of primary and metastatic disease in the upper extremity. Historically, the goal of a hemiarthroplasty reconstruction was to provide a stable platform for hand and elbow function, with limited shoulder function. Techniques utilizing a reverse endoprosthesis (endoprosthetic replacement [EPR]) and allograft-prosthetic composite (APC) have been developed; however, there is a paucity of comparative studies.METHODS:
A total of 83 (42 females, 41 males) patients undergoing an intraarticular resection of the humerus were reviewed. Reconstructions included 30 reverse and 53 hemiarthroplasty; including hemiarthroplasty EPR (n = 36) and APC (n = 17), and reverse EPR (n = 20) and APC (n = 10).RESULTS:
Reverse reconstructions had improved forward elevation (85° vs. 44°, p < .001) and external rotation (30° vs. 21°; p < .001) versus a hemiarthroplasty. Reverse reconstructions had improved American Shoulder and Elbow Surgeons scores (65 vs. 57; p = .01) and Musculoskeletal Tumor Society 93 scores (72 vs. 63; p < .001) versus hemiarthroplasty. Subluxation of the reconstruction was a common (n = 23, 27%), only occurring in hemiarthroplasty patients (EPR [n = 13, 36%] and APC [n = 10, 59%]).CONCLUSION:
The current series highlights the improved functional outcome in patients undergoing reconstruction with a reverse arthroplasty compared to the traditional hemiarthroplasty. Currently reverse shoulder arthroplasty (APC or EPR) is our preferred methods of reconstruction in this patient population.Palabras clave
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Articulación del Hombro
/
Neoplasias Óseas
/
Condrosarcoma
/
Procedimientos de Cirugía Plástica
/
Hemiartroplastia
/
Artroplastía de Reemplazo de Hombro
/
Húmero
Tipo de estudio:
Observational_studies
/
Prognostic_studies
Límite:
Adult
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
J Surg Oncol
Año:
2021
Tipo del documento:
Article
País de afiliación:
Estados Unidos