title: Proximal and total humerus reconstruction with the use of an aortograft mesh.
abstract: BACKGROUND
  The shoulder is commonly affected by primary and metastatic tumors. Current surgical techniques for complex shoulder reconstruction frequently result in functional deficits and instability. A synthetic mesh used in vascular surgery has the biological properties to provide mechanical constraint and improve stability after tumor related shoulder reconstruction.
  
  
  OBJECTIVE
  We describe (1) surgical technique using a synthetic mesh during humerus reconstructions; (2) functional level defined as shoulder ROM of patients undergoing the procedure; (3) incidence of postoperative dislocation and shoulder instability; and (4) complications associated with the use of the device.
  
  
  METHODS
  We retrospectively reviewed 16 patients with proximal humerus replacements reconstructed with a synthetic mesh from February 2006 to July 2008. Patients were followed clinically and radiographically for a minimum of 13 months (mean, 26 months; range, 13-43 months).
  
  
  RESULTS
  There were no shoulder dislocations at the latest followup. The mean shoulder flexion was 43° (range, 15°-170°) and mean shoulder abduction of 38 (range, 15°-110°). The mean operative time was 121 minutes (range, 80-170 minutes) and the mean blood loss was 220 mL (range, 50-750 mL). One patient had a superficial wound infection and none a deep infection requiring removal of the graft or prosthesis.
  
  
  CONCLUSIONS
  The data suggest the use of a synthetic vascular mesh for proximal humerus reconstruction may reduce dislocations and facilitate soft tissue attachment and reconstruction after tumor resection.
authors.affiliation: Department of Orthopaedics and Sports Medicine, University of South Florida, 13220 USF Laurel Drive, Tampa, FL 33613, USA. germarulo@hotmail.com
authors.forename: German A
authors.initials: GA
authors.lastname: Marulanda
authors.forename: Eric
authors.initials: E
authors.lastname: Henderson
authors.forename: David
authors.initials: D
authors.lastname: Cheong
authors.forename: G Douglas
authors.initials: GD
authors.lastname: Letson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001807:Blood Vessel Prosthesis; D001859:Bone Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D005431:Florida; D006801:Humans; D006811:Humerus / Q000000981:diagnostic imaging / Q000601:surgery*; D007593:Joint Instability / Q000209:etiology / Q000517:prevention & control; D023821:Limb Salvage; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000009:adverse effects / Q000295:instrumentation*; D011138:Polytetrafluoroethylene; D011474:Prosthesis Design; D019919:Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation*; D011859:Radiography; D016059:Range of Motion, Articular; D020127:Recovery of Function; D012189:Retrospective Studies; D012783:Shoulder Dislocation / Q000209:etiology / Q000517:prevention & control; D012785:Shoulder Joint / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D013526:Surgical Mesh; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D011138:Polytetrafluoroethylene