title: Reconstruction of the proximal humerus for bone neoplasm using an anatomic prosthesis-bone graft composite.
abstract: This study assesses function after limb sparing bone tumour resections of the proximal humerus. Twenty-seven patients had an intraarticular resection with reconstruction using an anatomic prosthesis-bone graft composite with average clinical follow-up of 63 years (range: 13-15.8 years). Pain relief was achieved for 22 shoulders (81%); 19 of 25 patients responding (76%) were satisfied. Active elevation averaged 62 degrees, external rotation 25 degrees, and internal rotation to L-4. Complications included instability in 7, nonunion in 4, implant loosening in 3 of these and tumour recurrence in 1. There were 7 reoperations. Using the Neer rating, 19 primary operations (70%) were successful. The Musculoskeletal Tumor Society Score averaged 18.5 (62%), the American Shoulder and Elbow Surgeons functional score 18.4 (37%) with a total score of 51 (51%), and on the Simple Shoulder Test 5.4 of 12 questions were answered affirmatively. This procedure is oncologically safe. There are structural complications, notably shoulder instability. Function ratings are one-third to one-half normal.
authors.affiliation: Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN 55905, USA.
authors.forename: David E
authors.initials: DE
authors.lastname: Hartigan
authors.forename: Christian J H
authors.initials: CJ
authors.lastname: Veillette
authors.forename: Joaquin
authors.initials: J
authors.lastname: Sanchez-Sotelo
authors.forename: John W
authors.initials: JW
authors.lastname: Sperling
authors.forename: Thomas C
authors.initials: TC
authors.lastname: Shives
authors.forename: Robert H
authors.initials: RH
authors.lastname: Cofield
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001859:Bone Neoplasms / Q000473:pathology / Q000601:surgery*; D016025:Bone Transplantation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006811:Humerus / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D019736:Prostheses and Implants; D019651:Plastic Surgery Procedures / Q000379:methods*; D016896:Treatment Outcome