title: Does reverse shoulder arthroplasty for tumors of the proximal humerus reduce impairment?
abstract: BACKGROUND
  Normal function of the upper limb is seldom restored after limb-sparing surgery for tumors of the proximal humerus. The literature suggests superior shoulder function is achieved in the short term with reverse total shoulder arthroplasty compared to other techniques when performed for conditions with rotator cuff deficiency. It is unclear whether this superiority is maintained when reverse total shoulder arthroplasty is performed for tumors.
  
  
  OBJECTIVE
  When performed for tumors, we determined whether reverse total shoulder arthroplasty restores function and improves motion, the complications associated with the surgery, and whether reverse total shoulder arthroplasty with autologous grafting is associated with bone resorption.
  
  
  METHODS
  We retrospectively reviewed 14 patients who had undergone reverse total shoulder arthroplasty for tumors of the proximal humerus. Four patients died, leaving nine patients for review. The surviving patients were evaluated clinically and radiographically. The minimum followup was 0.6 years (mean, 7.7 years; range, 0.6-12 years).
  
  
  RESULTS
  At last followup, mean active abduction was 157° and mean functional Constant-Murley score was 76%. One patient had a deep infection and one developed a loose prosthesis; both were treated with single-stage exchange. At last followup, both patients had reasonable function without evidence of infection or loosening. Radiographic graft resorption was seen in all but one patient.
  
  
  CONCLUSIONS
  Our observations suggest, at medium-term followup, reverse total shoulder arthroplasty is a reasonable option for tumors of the proximal humerus. It has low morbidity, restores a mean active abduction of 157°, and limits the impairment of activities of daily living.
  
  
  METHODS
  Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
authors.affiliation: Department of Orthopaedic Surgery and Traumatology, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium. lieven.dewilde@UGent.be
authors.forename: Lieven
authors.initials: L
authors.lastname: De Wilde
authors.forename: Pascal
authors.initials: P
authors.lastname: Boileau
authors.forename: Hans
authors.initials: H
authors.lastname: Van der Bracht
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D019643:Arthroplasty, Replacement / Q000009:adverse effects; D001530:Belgium; D001696:Biomechanical Phenomena; D001859:Bone Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D001862:Bone Resorption / Q000209:etiology; D016025:Bone Transplantation / Q000009:adverse effects; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D006811:Humerus / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000209:etiology / Q000517:prevention & control; D018579:Patient Selection; D011859:Radiography; D016059:Range of Motion, Articular; D020127:Recovery of Function; D012189:Retrospective Studies; D012785:Shoulder Joint / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D020069:Shoulder Pain / Q000209:etiology / Q000517:prevention & control; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult