Functional outcome following endoprosthetic reconstruction of the proximal humerus

Advances in Segmental Endoprosthetic Reconstruction for Extremity Tumors: A Review of Contemporary Designs and Techniques

“…In these cases, soft-tissue reattachment is especially important to prevent future dislocations. 7,20,[48][49][50] Other materials and techniques are currently being investigated to improve soft-tissue integration. 16,[25][26][27][28]36,[38][39][40]67 In the proximal tibia, the gastrocnemius fl ap can be reinforced using various materials such as artifi cial acrylic meshes (eg, Lars, Trevira) or other biologically derived devices.…”

“…57,[98][99][100] Aseptic loosening (type II failure) is a frequent mechanical complication in megaprosthetic reconstructions of long bones after tumor resection. [46][47][48][49]52 Aseptic loosening of the stem is the most prominent and variably reported complication in the literature, with an incidence ranging from 3% to 27%. 38,46,49,64,91,92,101 The mode of stem fi xation, cemented vs uncemented, is of remarkable importance, and currently there is no clear distinction in outcomes between the two.…”

“…38,46,49,64,91,92,101 The mode of stem fi xation, cemented vs uncemented, is of remarkable importance, and currently there is no clear distinction in outcomes between the two. 48,63,64,90,94,101 Cemented stems in these reconstructions have been reported in most of the literature as having a higher rate of aseptic loosening; however, this evidence should be critically regarded since many of these studies are retrospective. Currently, no prospective randomized evidence exists demonstrating the superiority of either mode of fi xation.…”

“…Additionally, aseptic loosening of humeral endoprostheses, a non-weightbearing joint, occurs less often due to decreased implant and interface stresses, further outlining the role that biomechanical forces have on long-term survivorship. [47][48][49] Polymethylmethacrylate (PMMA) cement has been a reliable means of early-and long-term fi xation of segmental endoprosthetic devices. 46,50,51 Benefi ts of cementation are its abilities to withstand immediate weight-bearing of the extremity and provide excellent stability against compressive loads.…”

Replacement of the proximal humerus with MUTARS tumor endoprostheses

“…The clinical outcome, local recurrence, and survival rates after limb-preserving and other procedures seem to be comparable [9][10][11]. To provide a platform for elbow and hand function, reconstructive limb-preserving procedures have been proposed for the proximal humerus [12]. Moreover, patient acceptance has been described as higher for limb-preserving treatments.…”