No abstract

The overall survivorship in patients with appendicular osteosarcoma has increased in the past few decades. However, controversies and questions about performing an amputation or a limb salvage procedure still remain. Using three peer-reviewed library databases, a systematic review of the literature was performed to evaluate all studies that have evaluated the outcomes of appendicular osteosarcoma, either with limb salvage or amputation. The mean 5-year overall survivorship was 62% for salvage and 58% for amputation ( > 0.05). At mean 6-year follow-up, the local recurrence rates were 8.2% for salvage and 3.0% for amputation ( > 0.05). Additionally, at mean 6-year follow-up, the rate for metastasis was 33% for salvage and 38% for amputation ( > 0.05). The revision rates were higher with salvage (31 vs. 28%), and there were more complications in the salvage groups (52 vs. 34%; > 0.05). Despite the heterogeneity of studies available for review, we observed similar survival rates between the two procedures. Although there was no significant statistical difference between rates of recurrence and metastasis, the local recurrence rate and risk of complications were higher for limb salvage as compared to amputation. Cosmetic satisfaction is often higher with limb salvage, whereas long-term expense is higher with amputation. Overall, current literature supports limb salvage procedures when wide surgical margins can be achieved while still retaining a functional limb.

* The most common indication for reverse total shoulder arthroplasty is primary rotator cuff tear arthropathy.* Indications for reverse total shoulder arthroplasty have expanded beyond rotator cuff tear arthropathy to include other pathologies such as irreparable rotator cuff tears, glenohumeral arthritis with an intact rotator cuff, acute proximal humeral fractures, the sequelae of proximal humeral fractures, neoplasms of the proximal part of the humerus, inflammatory arthropathies, and failed total shoulder arthroplasty and hemiarthroplasty.* Reverse total shoulder arthroplasty continues to have high rates of complications, which include instability, infection, scapular notching, neurologic injury, and component loosening, among others.

Cross-sectional study.