title: New endoprosthesis suspension method with polypropylene monofilament knitted mesh after resection of bone tumors in proximal humerus.
abstract: BACKGROUND
  Endoprosthetic reconstruction of the proximal humerus is one of the standard procedures after resection of tumors of the proximal humerus and has been considered a reliable method to reconstruct the proximal humerus in recent reports. However, instability of the shoulder joint caused by loss of the rotator cuff and deltoid muscle function is often observed after such an endoprosthetic reconstruction.
  
  
  METHODS
  We performed the endoprosthesis suspension method with polypropylene monofilament knitted mesh. This suspension method, by which the endoprosthesis is suspended from the bone structure, was used after resection of tumors in 9 patients. We assessed postoperative stability of the shoulder joint by comparing these patients with 12 patients who underwent the conventional surgical technique, by which the mesh-wrapped endoprosthesis is attached only to soft tissue.
  
  
  RESULTS
  In radiographic and physical evaluation, 4 of the 12 patients in the soft tissue reconstruction group showed shoulder joint instability. No patient in the suspension method group showed subluxation of the humeral prosthesis. The mean shoulder flexion was 35° and 65° and the mean shoulder abduction was 40° and 40° for the soft tissue reconstruction group and the suspension method group, respectively.
  
  
  CONCLUSIONS
  Shoulder joint subluxation sometimes occurs because of elongation of the attached soft tissue in the conventional reconstruction with mesh, whereas no shoulder joint subluxation occurs after endoprosthetic reconstruction in the suspension method because the bone structure has no leeway for elongation. Excellent stability of our new method enables exercise of the surgical shoulder at an early stage, leading to improved range of shoulder joint motion.
authors.affiliation: Department of Orthopaedic Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto, Tokyo, Japan. Electronic address: buchi@m.ehime-u.ac.jp.
authors.forename: Taketsugu
authors.initials: T
authors.lastname: Fujibuchi
authors.affiliation: Department of Orthopaedic Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto, Tokyo, Japan.
authors.forename: Seiichi
authors.initials: S
authors.lastname: Matsumoto
authors.affiliation: Department of Orthopaedic Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto, Tokyo, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Shimoji
authors.affiliation: Department of Orthopaedic Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto, Tokyo, Japan.
authors.forename: Keisuke
authors.initials: K
authors.lastname: Ae
authors.affiliation: Department of Orthopaedic Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto, Tokyo, Japan.
authors.forename: Taisuke
authors.initials: T
authors.lastname: Tanizawa
authors.affiliation: Department of Orthopaedic Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto, Tokyo, Japan.
authors.forename: Tabu
authors.initials: T
authors.lastname: Gokita
authors.affiliation: Department of Orthopaedic Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto, Tokyo, Japan.
authors.forename: Keiko
authors.initials: K
authors.lastname: Hayakawa
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001859:Bone Neoplasms / Q000601:surgery*; D057645:Deltoid Muscle / Q000601:surgery; D004838:Epiphyses; D005260:Female; D006801:Humans; D006811:Humerus; D007593:Joint Instability / Q000000981:diagnostic imaging / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D011126:Polypropylenes; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000209:etiology*; D019919:Prosthesis Implantation / Q000295:instrumentation / Q000379:methods*; D011859:Radiography; D016059:Range of Motion, Articular; D017006:Rotator Cuff / Q000601:surgery; D012785:Shoulder Joint / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D013526:Surgical Mesh; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D011126:Polypropylenes
keywords: Bone tumor; artificial mesh; endoprosthesis; shoulder joint