Proximal and total humerus reconstruction with the use of an aortograft mesh.
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.
Marulanda
German A
GA
Department of Orthopaedics and Sports Medicine, University of South Florida, 13220 USF Laurel Drive, Tampa, FL 33613, USA. germarulo@hotmail.com
Henderson
Eric
E
Cheong
David
D
Letson
G Douglas
GD
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
D011138:Polytetrafluoroethylene