New endoprosthesis suspension method with polypropylene monofilament knitted mesh after resection of bone tumors in proximal humerus

Fujibuchi, Taketsugu; Matsumoto, Seiichi; Shimoji, Takeyoshi; Ae, Keisuke; Tanizawa, Taisuke; Gokita, Tabu; Hayakawa, Keiko

doi:10.1016/j.jse.2014.10.011

Cited by 16 publications

(16 citation statements)

References 25 publications

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“…6 This number is similar to the 33.3% of shoulder instability observed by Fujibuchi et al, although these patients had received a proximal humeral endoprosthesis wrapped in PMKM (Marlex mesh or Bard mesh, Warwick, RI, USA) fixed to soft tissues (4/12). 7 On the other hand, the same mesh fixed to bone resulted in less shoulder instability (0/9) and better shoulder flexion (65° vs. 35° in the soft tissue suspension group; no p-value provided by authors). 7…”

Section: Resultsmentioning

confidence: 90%

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Advances in tumour endoprostheses: a systematic review

et al. 2019

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Tumour endoprostheses have facilitated limb-salvage procedures in primary bone and soft tissue sarcomas, and are increasingly being used in symptomatic metastases of the long bones. The objective of the present review was to analyse articles published over the last three years on tumour endoprostheses and to summarize current knowledge on this topic. The NCBI PubMed webpage was used to identify original articles published between January 2015 and April 2018 in journals with an impact factor in the top 25.9% of the respective category (orthopaedics, multidisciplinary sciences). The following search-terms were used: tumour endoprosthesis, advances tumour endoprosthesis, tumour megaprosthesis, prosthetic reconstruction AND tumour. We identified 347 original articles, of which 53 complied with the abovementioned criteria. Articles were categorized into (1) tumour endoprostheses in the shoulder girdle, (2) tumour endoprostheses in the proximal femur, (3) tumour endoprostheses of the knee region, (4) tumour endoprostheses in the pelvis, (5) (expandable) prostheses in children and (6) long-term results of tumour endoprostheses. The topics of interest covered by the selected studies largely matched with the main research questions stated at a consensus meeting, with survival outcome of orthopaedic implants being the most commonly raised research question. As many studies reported on the risk of deep infections, research in the future should also focus on potential preventive methods in endoprosthetic tumour reconstruction. Cite this article: EFORT Open Rev 2019;4:445-459. DOI: 10.1302/2058-5241.4.180081

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Section: Resultsmentioning

confidence: 90%

“…7 On the other hand, the same mesh fixed to bone resulted in less shoulder instability (0/9) and better shoulder flexion (65° vs. 35° in the soft tissue suspension group; no p-value provided by authors). 7…”

Section: Resultsmentioning

confidence: 90%

Advances in tumour endoprostheses: a systematic review

et al. 2019

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“…[1,4,13] However, although the shoulder function could be preserved by the conventional PHP, it was unsatisfied because of damage of the abductor mechanisms and the unconstrained design of the prosthesis. Therefore, modified endoprosthetic reconstruction, for example reverse shoulder endoprosthesis, [16,21] using synthetic mesh for enhancing soft-tissue attachment, [10,22] etc, had been reported to improve the functional outcome. In this study, the overall functional outcome was consistent with that in literatures.…”

Section: Discussionmentioning

confidence: 99%

Plate-prosthesis composite reconstruction after large segmental resection of proximal humeral tumors

et al. 2019

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Since the standard reconstructive option after large segmental resection of proximal humeral tumors remained controversial, we designed and applied plate-prosthesis composite (PPC) for this circumstance. The purposes of the study were to: compare the functional outcome, implant survival (IS), surgical risk of PPC with those of conventional proximal humeral prosthesis (PHP); and describe the design and reconstructive procedure of PPC. Twenty patients (11 males, 9 females), who received intraarticular proximal humeral resection without preservation of abductor mechanism, were included in this study, with a mean resection length accounting for 72.5% (range, 61.9–81.8%) of whole humeral length. According to the reconstructive options, we categorized patients into PPC group (9 patients) and PHP group (11 patients). PPC was a semi-custom-made endoprosthesis, with modular proximal part same as PHP and custom-made distal part including dumpy stem and composite lateral anatomic plate for distal humerus. The mechanical prosthetic complication was defined as the imaging evidence regardless of reoperation. The IS was defined as the time from surgery to the occurrence of mechanical prosthetic complication. The mean follow-up time was 40.1 months (range, 14–129). The Musculoskeletal Tumor Society 93 scores of PPC and PHP group showed no significant difference (73.3% vs 70.0%, P = .46). Compared to PHP group, PPC group showed significantly lower mechanical prosthetic complication rates (0 vs 45.4%, P = .03) and better IS (86.0 vs 59.3 ± 21.7 months, P = .028). Moreover, the comparison of surgical time (3.2 vs 3.3 hours, P = .60), blood loss (288.9 vs 376.4 mL, P = .15) and perioperative complication rates (11.1% vs 18.2%, P = .58) between 2 groups showed no differences. For reconstruction after large segmental resection of proximal humeral tumors, PPC achieved better IS while maintained similar functional outcome compared to conventional PHP without influencing the complexity and safety of surgery.

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“…[3][4][5]14,15 However, subluxation and proximal migration of the humeral component is a common complication, with rates as high as 76% with the use of a hemiarthroplasty EPR or APC. 5,13,14,[32][33][34] Historically, the goal of treatment for patients with metastatic disease was to provide palliative pain relief. However, with advances in targeted therapies, [35][36][37] patients with metastatic disease are living longer and require durable reconstructive procedures.…”

Section: Postoperative Complicationsmentioning

confidence: 99%

Comparison of reconstructive techniques following oncologic intraarticular resection of proximal humerus

Houdek

Bukowski

Athey

et al. 2020

Journal of Surgical Oncology

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Introduction: The proximal humerus is a common site of primary and metastatic disease in the upper extremity. Historically, the goal of a hemiarthroplasty reconstruction was to provide a stable platform for hand and elbow function, with limited shoulder function. Techniques utilizing a reverse endoprosthesis (endoprosthetic replacement [EPR]) and allograft-prosthetic composite (APC) have been developed; however, there is a paucity of comparative studies. Methods: A total of 83 (42 females, 41 males) patients undergoing an intraarticular resection of the humerus were reviewed. Reconstructions included 30 reverse and 53 hemiarthroplasty; including hemiarthroplasty EPR (n = 36) and APC (n = 17), and reverse EPR (n = 20) and APC (n = 10). Results: Reverse reconstructions had improved forward elevation (85°vs. 44°, p < .001) and external rotation (30°vs. 21°; p < .001) versus a hemiarthroplasty. Reverse reconstructions had improved American Shoulder and Elbow Surgeons scores (65 vs. 57; p = .01) and Musculoskeletal Tumor Society 93 scores (72 vs. 63; p < .001) versus hemiarthroplasty. Subluxation of the reconstruction was a common (n = 23, 27%), only occurring in hemiarthroplasty patients (EPR [n = 13, 36%] and APC [n = 10, 59%]). Conclusion: The current series highlights the improved functional outcome in patients undergoing reconstruction with a reverse arthroplasty compared to the traditional hemiarthroplasty. Currently reverse shoulder arthroplasty (APC or EPR) is our preferred methods of reconstruction in this patient population.

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New endoprosthesis suspension method with polypropylene monofilament knitted mesh after resection of bone tumors in proximal humerus

Cited by 16 publications

References 25 publications

Advances in tumour endoprostheses: a systematic review

Advances in tumour endoprostheses: a systematic review

Plate-prosthesis composite reconstruction after large segmental resection of proximal humeral tumors

Comparison of reconstructive techniques following oncologic intraarticular resection of proximal humerus

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