Reconstruction by allograft-prosthetic composite reverse shoulder arthroplasty after proximal humerus tumor resection: clinical and radiographic assessment at a minimum 2 years' follow-up.

Orthopaedics & Traumatology, Surgery & Research : OTSR
Gabriel CallamandNicolas Bonnevialle

Abstract

Reverse shoulder arthroplasty (RSA) is an option to conserve limb function after resection of proximal humerus malignancy. An allograft-composite RSA is an alternative to a tumor prosthesis, and can restore proximal humeral bone stock. The aim of the present study was to assess medium-term radiographic and clinical results for such composite implants. Patients with malignant proximal humerus tumor treated by resection and reconstruction by composite RSA were retrospectively analyzed at a minimum 24 months' follow-up. Clinical assessment used Constant score, Subjective Shoulder Value (SSV) and ADLER score. Standard radiographic work-up assessed allograft absorption and screened for implant loosening. Eleven patients were included, with a mean age of 51 years (range, 19-87 years) and mean 30 months' follow-up (range, 24-84 months). Mean tumor resection was 10 cm (range, 6-17 cm). Etiologies comprised chondrosarcoma (n=6), osteosarcoma (n=2), B-cell lymphoma (n=1) and single metastasis (n=2). Bony increased-offset allograft was associated to humerus reconstruction in 8 cases, and latissimus dorsi tendon transfer in 5 cases. Mean Constant score was 49 points, SSV 52%, and ADLER score 20 points. Increased glenoid implant offset asso...Continue Reading

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