Endoprosthetic Reconstruction for Malignant Upper Extremity Tumors

Asavamongkolkul, Apichat; Eċkardt, Jeffrey J.; Eilber, Frederick R.; Dorey, Frederick J.; Ward, William G.; Kelly, Cynthia M.; Wirganowicz, Philip Z.; Kabo, J. Michael

doi:10.1097/00003086-199903000-00025

Cited by 100 publications

(72 citation statements)

References 16 publications

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“…There were no cases of infections: two patients showed superficial wound-healing disturbance that resolved under conservative management. Functional outcome was assessed according to the MSTS score, including data on pain, function, emotion, hand position, manual dexterity and lifting ability [7,12,13]. Mean MSTS score for eight patients who had their limb salvaged was 80% (24 points).…”

Section: Resultsmentioning

confidence: 99%

“…The major advantages are early functional recovery, a relatively low complication rate and high level of emotional acceptance. Full range of shoulder movements cannot be achieved by available methods of reconstruction after resections that sacrifice a part or all of the rotator cuff and deltoid [7][8][9][10]14]. There was significant loss of shoulder abduction and flexion in all patients.…”

Section: Discussionmentioning

confidence: 95%

“…The use of allografts, alloprosthetic composites and prosthetic replacements to reconstruct the proximal humerus after tumour resection and associated complications have been well described [5][6][7][8][9]11]. However, extensive tumours of the humerus, large tumours of the diaphysis and local recurrent disease after limb-salvage surgery present unique problems with respect to reconstruction options.…”

Section: Introductionmentioning

confidence: 99%

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Custom-made endoprosthetic total humerus reconstruction for musculoskeletal tumours

Natarajan

Sameer

Dheep

et al. 2011

International Orthopaedics (SICOT)

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Purpose We analysed 11 patients with malignant musculoskeletal tumours of the humerus who underwent limb salvage surgery with total humeral custom endoprosthesis from 1990 to 2009. Methods There were six male and five female patients, with a mean age of 17 years. The most common diagnosis was osteosarcoma. The average follow-up period was 66 months, with the maximum being 180 months. Functional and oncological outcomes were analysed. Results The one and five year cumulative survival (Kaplan-Meier method) rates were 90.9% and 77.9 %. The average Musculoskeletal Tumour Society Score (MSTS) was 80%. Two patients died due to metastasis. One patient had a forequarter amputation for local recurrence. The procedure provides fast recovery and relatively good restoration of elbow function, whereas active shoulder movements remain limited Conclusion Total humeral custom endoprosthetic replacement represents a viable treatment option in indicated patients, providing reliable and reasonable function of the upper limb, with a low complication rate.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

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Custom-made endoprosthetic total humerus reconstruction for musculoskeletal tumours

Natarajan

Sameer

Dheep

et al. 2011

International Orthopaedics (SICOT)

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“…Asavamongkolkul et al 17 reported 6 of the 59 patients had subluxation or dislocation of the shoulder and 2 had infections. Local recurrence after limb salvage has been reported to range from 0% to 12%.…”

Section: Discussionmentioning

confidence: 99%

Endoprosthetic replacement versus cement spacer in reconstruction of proximal humerus after tumor resection: Cost and benefits

Rafalla

Abdullah

2017

Journal of Orthopaedic Surgery

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Background: Proximal end of the humerus is a common site for both primary and metastatic bone tumors. Limb salvage with endoprosthetic replacement is the most common means of reconstruction, but it has been proved that cement spacer are more beneficial for inferior shoulder function. Thus, limb salvage can be replaced by cheaper spacers especially in poor societies. Patients and methods: This study included 20 patients, of whom 14 were female, with a mean age of 40.4 years (range 12-60). Among the study population, six were diagnosed with osteosarcomas, two chondrosarcomas, two myeloma, two lymphoma, four metastatic carcinoma in the breast, two giant cell tumor, and two recurrent chondroplastoma. Limb salvage was successfully done in all patients: Tikhoff-Linberg type I in 12 cases and type V in 8. Endoprosthetic replacement was done in eight cases. An on-table fabricated cement spacer was used in 12 cases. Results: Follow-up ranged from 12 to 75 months, with a mean of 25.9 months. Functional outcome was almost comparable in both types of reconstruction, especially patient's satisfaction, with a mean function of 65%. Conclusion: A relatively expensive endoprosthesis could be replaced by a much cheaper cement spacer if their function is comparable.

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“…Currently, limb salvage surgery is accepted as the gold standard in orthopaedic oncology and, following tumour resection, frequently involves limb reconstruction with an endoprosthesis [3,4]. Due to modern advances in chemotherapy, many patients with these and other malignant bone sarcomas will go on to have a relatively normal lifespan [1,2].…”

Section: Introductionmentioning

confidence: 99%

Early follow-up of a custom non-fluted diaphyseal press-fit tumour prosthesis

O’Donnell

Griffin

Eward

et al. 2013

International Orthopaedics (SICOT)

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Purpose The objective of this study was to evaluate the early results of a custom non-fluted diaphyseal press-fit stem for use with the global modular replacement system (GMRS) tumour prosthesis and the early complications associated with this implant. Methods A total of 53 patients (54 implants) were identified from a prospective database where a custom non-fluted diaphyseal press-fit stem was used as part of the reconstruction of the limb. All patients had a minimum of 22 months of follow-up. Results The rates of stem revision for any reason were calculated. The median follow-up was 36 months (range 22-85 months). Aseptic loosening was not observed in any patient. Conclusions At early term follow-up, an uncemented nonfluted stem used with the GMRS tumour endoprosthesis provides a stable bone-prosthesis interface with no evidence of aseptic loosening.

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Endoprosthetic Reconstruction for Malignant Upper Extremity Tumors

Cited by 100 publications

References 16 publications

Custom-made endoprosthetic total humerus reconstruction for musculoskeletal tumours

Custom-made endoprosthetic total humerus reconstruction for musculoskeletal tumours

Endoprosthetic replacement versus cement spacer in reconstruction of proximal humerus after tumor resection: Cost and benefits

Early follow-up of a custom non-fluted diaphyseal press-fit tumour prosthesis

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