Results of the proximal humerus endoprosthetic reconstruction after tumour resection
- Authors: Mikailov I.M.1, Grigoriev P.V.1, Ptashnikov D.A.1, Maykov S.V.1
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Affiliations:
- Vreden Russian Research Institute of Traumotology and Orthopedics
- Issue: Vol 20, No 4 (2014)
- Pages: 27-35
- Section: Clinical studies
- Submitted: 12.09.2016
- Published: 12.12.2014
- URL: https://journal.rniito.org/jour/article/view/95
- DOI: https://doi.org/10.21823/2311-2905-2014-0-4-27-35
- ID: 95
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Full Text
Abstract
The purpose of the study was to evaluate the results of surgical reconstructions of the proximal humerus after transarticular tumour resection, compare the functional results with the results of shoulder arthroplasty in patients with extensive damage of the proximal humerus of non-neoplastic origin. Material and methods. Between 2001 and 2013 38 proximal humeral reconstructions were performed in our clinic: using monopolar endoprostheses - 26 (68%) and modular systems with reversible head -12 (32%). The control group included 46 patients with extensive lesions of the proximal humerus of non-neoplastic origin, operated in our clinic in the period from 2006 to 2012. Term follow-up of patients ranged from 7 months to 9 years. Assessment of functional results was carried out in a period from six months to one year. Results. The seven-year survival according the Kaplan - Meier method for patients with primary malignant tumors of the proximal humerus (25 patients) was 77%. In the study group the average value of functional outcome MSTS score was 77.7%. Unipolar prosthesis showed a bad result, both in the control (61,3% MSTS, 60,7 Neer) and in the main (67,7% MSTS, 61,1 Neer) study groups. Conclusion. Currently the method of choice which doesn’t impair the oncologic component of treatment patients with shoulder neoplastic lesions is its replacement with modular reversible systems in combination with additional soft tissue fixation.
About the authors
I. M. Mikailov
Vreden Russian Research Institute of Traumotology and Orthopedics
Author for correspondence.
Email: mim17@mail.ru
Россия
P. V. Grigoriev
Vreden Russian Research Institute of Traumotology and Orthopedics
Email: noemail@neicon.ru
Россия
D. A. Ptashnikov
Vreden Russian Research Institute of Traumotology and Orthopedics
Email: noemail@neicon.ru
Россия
S. V. Maykov
Vreden Russian Research Institute of Traumotology and Orthopedics
Email: noemail@neicon.ru
Россия
References
- Алиев М.Д., Соколовский В.А., Дзампаев А.З., Нисиченко Д.В., Сергеев П.С., Хестанов Д.Б. Отдаленные результаты применения мегапротезов в хирургии опухолей костей и суставов. Вестник московского онкологического общества. 2011; (4). Режим доступа netoncology.ru/.uploads/ press/1191/V-11-0495.file.doc (дата посещения 22.09.2014)
- Майков С.В. Пути повышения эффективности эндопротезирования плечевого сустава. Дис. канд. мед. наук. СПб.; 2012.
- Тепляков В.В., Карпенко В.Ю., Франк Г.А., Буланов А.А., Державин В.А., Шаталов А.М. Эндопротезирование при опухолевом поражении длинных костей. Российский онкологический журнал: 2009; (5):11-14.
- Тепляков В.В., Карпенко В.Ю., Шаталов А.М., Бухаров В.А., Державин В.А., Мысливцев И.В. Эндопротезирование длинных трубчатых костей и суставов при дефиците мягких тканей. Вестник московского онкологического общества. 2011 (4). Режим доступа netoncology.ru/.uploads/press/1191/V-11-0495.file. doc (дата посещения 22.09.2014)
- Aponte-Tinao L.A., Ayerza M.A., Muscolo D.L., Farfalli G.L. Allograft reconstruction for the treatment of musculoskeletal tumors of the upper extremity. Sarcoma. 2013;2013:925413.
- Cannon C.P., Paraliticci G.U., Lin P.P., Lewis V.O., Yasko A.W. Functional outcome following endoprosthetic reconstruction of the proximal humerus. J Shoulder Elbow Surg. 2009;18:705-710.
- Enneking W.F., Dunham W., Gebhardt M.C., Malawer M., Pritchard D.J. A system for the functional evaluation of reconstructive procedures after surgical treatment of tumors of the musculoskeletal system. Clin Orthop. 1993;(286):241-246.
- Enneking W.F. Modification of the system for functional evaluation of surgical management of musculoskeletal tumors. In: Bristol-Myers/Zimmer Orthopaedic Symposium. Limb salvage in musculoskeletal oncology. New York: Churchill Livingstone; 1987. P. 626-639.
- Fuhrmann R.A., Roth A., Venbrocks R.A. Salvage of the upper extremity in cases of tumorous destruction of the proximal humerus. J Cancer Res Clin Oncol. 2000; 126:337-344.
- Manfrini M., Vanel D., De Paolis M., Malaguti C., Innocenti M., Ceruso M., Capanna R., Mercuri M. Imaging of vascularized fibula autograft placed inside a massive allograft in reconstruction of lower limb bone tumors. Am J Roentgenol. 2004;15(4):963-970.
- Mayilvahanan N., Paraskumar M., Sivaseelam A., Natarajan S. Custom mega-prosthetic replacement for proximal humeral tumours. Int Orthop. 2006;30:158-162.
- Neer C.S. Displaced proximal humeral fractures. I. Classification and evaluation. J Bone Joint Surg Am. 1970;52:1077-1089.
- Potter B.K., Adams S.C., Pitcher J.D. Jr, Malinin T.I., Temple H.T. Proximal humerus reconstructions for tumors. Clin Orthop. 2009;467:1035-1041.
- Raiss P., Kinkel S., Sauter U., Bruckner T., Lehner B. Replacement of the proximal humerus with MUTARS tumor endoprostheses. Eur J Surg Oncol. 2010;36:371-377.
- Rispoli D.M., Athwal G.S., Sperling J.W., Cofield R.H. The anatomy of the deltoid insertion. J Shoulder Elbow Surg. 2009;18:386-390.
- Rödl R.W., Gosheger G., Gebert C., Lindner N., Ozaki T., Winkelmann W. Reconstruction of the proximal humerus after wide resection of tumours. J Bone Joint Surg Br. 2002;84:1004-1008.
- Van de Sande M.A., Dijkstra P.D., Taminiau A.H. Proximal humerus reconstruction after tumour resection: biological versus endoprosthetic reconstruction. Int Orthop. 2011;15(9):1375-1380.
- Yang Q., Li J., Yang Z., Li X., Li Z. Limb sparing surgery for bone tumours of the shoulder girdle: the oncological and functional results. Int. Orthop. 2010;15(6):869-875.