title: Treatment and outcome of malignant bone tumors of the proximal humerus: biological versus endoprosthetic reconstruction.
abstract: BACKGROUND
  The purpose of this study was to compare the outcome, complications and survival of the commonly used surgical reconstructions of the proximal humerus after intrarticular tumour resection in our hospital.
  
  
  METHODS
  Between 1998 and 2010, 41 consecutive proximal humeral reconstructions using prosthesis (group P, n = 25) or recycled pasteurized autograft combined with non-vascularised fibula autograft (group B, n = 16) were performed.
  
  
  RESULTS
  The mean follow-up was 57.7 months. Fourteen patients (8 patients in group P and 6 in group B) died during the follow-up period, the disease-specific survival of patients in group P was 74.5% at 5 years and in group B was 67.0%. Local recurrences were occurred in 3 cases (12.0%) in group P and 2 (12.5%) in group B. Pulmonary metastases were observed in 4 patients (16.0%) in group P and 4 (25.0%) in group B. There was no significant difference in the incidence of local recurrence, pulmonary metastasis or death of disease. Revisions were indicated in 9 patients (36.0%) in group P and 5 (31.25%) in group B. Thought the incidence of revisions was higher in group P, there was no significant difference in these two groups. The Kaplan-Meier 5-year implant survival estimates, with revision for any reason as the end point, were 80.6% and 68.8% for group P and group B, respectively. The mean MSTS Score was 63.6% in group P and 63.0% in group B. These differences were not statistically significant.
  
  
  CONCLUSIONS
  The study could show that prosthetic reconstruction and reconstruction with recycled pasteurized autograft are similar in terms of their local recurrence and metastasis, while the incidence of revisions was higher for patients with prosthetic reconstruction.
authors.forename: Tang
authors.initials: T
authors.lastname: Liu
authors.affiliation: Department of Orthopaedics, the Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, P,R, China. zhangqing65230@126.com.
authors.forename: Qing
authors.initials: Q
authors.lastname: Zhang
authors.forename: Xiaoning
authors.initials: X
authors.lastname: Guo
authors.forename: Xiangsheng
authors.initials: X
authors.lastname: Zhang
authors.forename: Zhihong
authors.initials: Z
authors.lastname: Li
authors.forename: Xiaoyang
authors.initials: X
authors.lastname: Li
mesh_terms: D000328:Adult; D001705:Bioprosthesis; D001859:Bone Neoplasms / Q000601:surgery*; D002813:Chondrosarcoma / Q000601:surgery; D018572:Disease-Free Survival; D005260:Female; D005360:Fibula / Q000637:transplantation; D005500:Follow-Up Studies; D051677:Histiocytoma, Malignant Fibrous / Q000601:surgery; D006801:Humans; D006811:Humerus / Q000601:surgery*; D053208:Kaplan-Meier Estimate; D023821:Limb Salvage; D008175:Lung Neoplasms / Q000556:secondary; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D012516:Osteosarcoma / Q000601:surgery; D019919:Prosthesis Implantation; D019651:Plastic Surgery Procedures; D012189:Retrospective Studies; D012512:Sarcoma, Ewing / Q000601:surgery; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D055815:Young Adult