Replacement of the proximal humerus with MUTARS tumor endoprostheses

Abstract

Background and Objectives: The aim of this study was to analyze our results using

Improvement of the shoulder function after large segment resection of the proximal humerus with the use of an inverse tumour prosthesis

“…Endoprosthetic reconstruction is described to have less procedure-related complications like implant failure, septic or aseptic loosening than other types of reconstruction. Although we are aware of the limitations of our study in terms of the short to medium follow-up of just 34 months and the limited number of 18 patients, our results are in concordance with data presented in the literature [12,22,23]. To mention, we did not see any loosening of the glenoid component, even in the patients with a longer follow-up and a good overall function, although this is a major concern in using inverse implants especially in Abduction ERO IRO 1 i 8 n d 29 130 60 180 50 50 2 i 11 n n 27 130 50 100 45 45 3 i 14 n n 26 85 60 85 50 40 4 i 13 y n 24 60 60 45 50 35 5 i 13 n n 28 160 40 100 40 40 6 i 16 y cd 20 10 10 10 5 5 7 i 20 n n 26 100 70 90 35 45 8 i 7 y n 2 3 5 0 3 i intact, p partially compromised, c complete transsection, d dislocation treated successfully, y yes, n no, cd chronic dislocation, ERO active external rotation, IRO active internal rotation young patients [18].…”

“…Hence, dislocation or subluxation of the PHP in up to 20 % due to insufficient soft tissue guidance is described as the main complication using anatomical shaped implants as well as using IPHP [11,12,16,21,23]. With two repetitive and two chronic dislocations we faced the same problem in our series.…”

Evaluation of a reconstruction reverse shoulder for tumour surgery and tribological comparision with an anatomical shoulder arthroplasty

“…The characteristics of the polyethylene used in the tumour prosthesis were compared with those of an anatomical shoulder prosthesis. A normal anatomical prosthesis was chosen because patients with an anatomical humerus replacement do not have good shoulder function [1,7,17], and wear is, therefore, not a reason for loosening of an anatomical proximal humerus replacement. Polyethylene wear particles have been observed in anatomical shoulder prostheses that have been removed after aseptic loosening associated with osteolysis [18,19].…”

Proximaler Humerusersatz bei malignen Schultergelenktumoren

“…B. Osteosarkom, Ewing-Sarkom, Chondrosarkom, malignes fibröses Histiozytom) hat sich insbesondere durch die Etablierung effektiver Chemotherapieprotokolle die weite Tumorresektion gegenüber radikalen Operationsverfahren, wie der Amputation, durchgesetzt [1,21]. Hierdurch ist der Erhalt der Extremität in der großen Mehrzahl der Fälle möglich und ablative Verfahren sind speziellen Ausnahmen vorbehalten [4,14,18].…”

“…Bis zum Tod des Patienten musste keine chirurgische Intervention vorgenommen werden. Vergleichbare Studien weisen z. T. höhe-re Infektionsraten von bis zu 10% auf [2,9,14,15,17,18].…”