Reverse shoulder arthroplasty after failed megaprosthesis for osteosarcoma of the proximal humerus: A case report and review of literature

Chauhan, Vikram Singh; Vaish, Abhishek; Vaishya, Raju

doi:10.1016/j.jcot.2019.03.015

Cited by 8 publications

(7 citation statements)

References 25 publications

(38 reference statements)

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“…The patient has undergone tumor resection, partial shoulder replacement megaprosthesis since this solution can ensure wide resection, but due to the loss of function of the rotator cuff tendon, which causes dislocation of the proximal humerus upward leading to pain and severe arm movement limitation. The patient was replaced with an inverted shoulder joint in 2017, which improved the function of the shoulder joint [ 29 ].…”

Section: Discussionmentioning

confidence: 99%

Reverse shoulder megaprosthesis replacement for aggressive aneurysm bone cyst of proximal humerus: Case report and literature review

Huu

Trung

Duc

et al. 2022

Annals of Medicine &Amp; Surgery

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Introduction and importance: Wide resection in the surgical treatment of aneurysms bone cysts is often performed in cases where the tumor is large, recurrent, growing, and intensely invasive. Reshaping the defect after tumor removal is a necessary issue to restore shape and maintain function for the patient. Case presentation A 26-year-old male patient, diagnosed with an aneurysm bone cyst in the proximal humerus, underwent surgery for curettage and bone grafting twice. After surgery, there was still pain in the shoulder area, the tumor progressed aggressively with limited shoulder movement. Based on the imaging re-evaluation, it was shown that the tumor increased rapidly in size, invaded the soft tissue, and completely changed the normal structure of the shoulder joint, and the proximal humerus. We used a reverse shoulder joint with an additional module to restore the bone defect of the tumor and the function of the shoulder joint. Follows-up showed that patient no longer pain in shoulder area, shoulder joint function recovery is progressing well, Musculoskeletal Tumor Society (MSTS) score is 25 & 28, shoulder joint function score according to ASES scale: 80 & 93.33 respectively at 3 months and 6 months after surgery. Clinical discussion Aggresive aneurysm bone cyst of proximal humerus is not common and still a challenge to the treatment. Due to the bone and joint destruction, the indication of tumor resection and reconstruct the joint and bone loss is required. Among several solution, reverse shoulder megaprosthesis is a newest one can favor the purpose of our treatment. Up to now, this solution is mainly used to preserving for malignant bone tumor. Conclusions Tumor wide resection with modular reverse shoulder replacement with the modular segment is a reasonable intervention option in cases of large aneurysm bone cysts, with rapid recurrence, aggressive progression, and soft tissue invasion.

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Section: Discussionmentioning

confidence: 99%

Reverse shoulder megaprosthesis replacement for aggressive aneurysm bone cyst of proximal humerus: Case report and literature review

Huu

Trung

Duc

et al. 2022

Annals of Medicine &Amp; Surgery

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“…There are currently some approaches available for the repair of tumorous defects involving the metaphysis, such as autograft, allograft, and prostheses ( Ruggieri et al, 2011 ; Wieser et al, 2013 ; King et al, 2016 ; Maclean et al, 2017 ; Rafalla and Abdullah, 2017 ; Nota et al, 2018 ; Chauhan et al, 2019 ). Autologous fibula graft has been widely applied in clinical settings because of its excellent biocompatibility and osteoinductivity ( Li et al, 2012 ; Pilge et al, 2018 ).…”

Section: Introductionmentioning

confidence: 99%

Three-dimensional-printed porous prosthesis for the joint-sparing reconstruction of the proximal humeral tumorous defect

Zhang

et al. 2023

Front. Bioeng. Biotechnol.

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Background: Tumorous bone defect reconstructions of the proximal humerus with joint sparing is a challenge. Numerous reconstruction methods have been proposed but the proximal residual humerus is commonly sacrificed because of its extremely short length. To preserve the proximal humerus and improve clinical outcomes, we designed a three-dimensional (3D) printed uncemented prosthesis with a porous structure to treat tumorous bone defects of the proximal humerus.Methods: Our analysis included seven patients treated between March 2018 and July 2019. A 3D model was established, and related data were obtained, including the diameter of the humeral head, the resection length, and the residual length. A prosthesis was designed and fabricated based on these data. Functional and oncologic outcomes were recorded, and complications and osseointegration were evaluated.Results: The mean age of the patients was 20.3 years, and the median follow-up period was 26 months. The lengths of the residual proximal humerus were 17.9 mm on average. All the patients had preserved humeral heads and most of the rotator cuff was intact. The average postoperative range of motion (ROM) of the affected shoulder was 83.8°; flexion was 82.5°, extension was 43.8°, and adduction was 16.3°. The average Musculoskeletal Tumor Society score (MSTS) was 94.3%. Good osseointegration was observed on the interface between the bone and prosthesis.Conclusion: A 3D printed porous prosthesis with cone-like structures successfully achieved joint-sparing reconstruction of proximal humeral tumorous defects with satisfying functional outcomes. The preservation of the rotator cuff and humeral head plays an essential role in the function of the shoulder joint.

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“…Although there is no consensus about the ideal method for reconstruction, proximal humeral replacement (PHR) with hemiarthroplasty is one of the most popular methods because of its convenience, good cosmetic appearance, and acceptable functional outcomes of the elbow and hand [1,3]. However, the function of the shoulder varies greatly among patients depending on the function of the axillary nerve and muscle reconstruction [6,[14][15][16]. Glenohumeral arthrodesis with bone grafts can achieve permanent stability once the graft heals and might improve the motion of the arm via the movement of the scapula [12,13,17].…”

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of a 3D-printed arthrodesis prosthesis for reconstruction after resection of the proximal humerus: preliminary outcomes with a minimum 2-year follow-up

Liang

Guo

Yang

et al. 2022

BMC Musculoskelet Disord

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Background The purpose of this study was to investigate the feasibility of using a three-dimensional (3D)-printed arthrodesis prosthesis for reconstruction of the proximal humeral defect after tumor resection. Methods A novel proximal humeral prosthesis was designed to restore bone continuity and shoulder arthrodesis and was fabricated via 3D printing technology. Ten patients with primary malignancies in the proximal humerus underwent intra-articular resection and replacement with this prosthesis from 2017 to 2019. Baseline and operative data, oncological and prosthetic survival, and functional status were summarized. Results This cohort consisted of 9 males and 1 female with a mean age of 32.1 ± 16.1 years. Diagnoses included 5 cases of osteosarcoma, 3 cases of chondrosarcoma and 1 each case of undifferentiated pleomorphic sarcoma and malignant myoepithelioma. The mean operative duration, intraoperative hemorrhage and postoperative length of hospitalization were 151.5 ± 61.0 min, 410.0 ± 353.4 ml and 5.3 ± 1.9 d, respectively. The mean follow-up duration was 29.3 ± 6.4 months, with a minimum of 24 months for the surviving patients. Two patients experienced local recurrence, and four patients developed distant metastases. Detachment of the taper occurred in two patients. One was managed conservatively, and the other received amputation due to concurrent tumor recurrence. The mean MSTS-93 and ASES scores and ranges of forwards flexion and abduction were 24.9 ± 3.1, 79.4 ± 8.3, 71.3 ± 19.4°, and 61.3 ± 16.4°, respectively. The functional outcomes were independent of the preservation of the axillary nerve. Histological study of the glenoid component showed evidence of bone ingrowth at the bone-prosthesis porous interface. Conclusion Application of the 3D-printed arthrodesis prosthesis might be a safe and efficacious method for functional reconstruction in patients who underwent resection of the proximal humerus, especially for those without preservation of the axillary nerve.

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Reverse shoulder arthroplasty after failed megaprosthesis for osteosarcoma of the proximal humerus: A case report and review of literature

Cited by 8 publications

References 25 publications

Reverse shoulder megaprosthesis replacement for aggressive aneurysm bone cyst of proximal humerus: Case report and literature review

Reverse shoulder megaprosthesis replacement for aggressive aneurysm bone cyst of proximal humerus: Case report and literature review

Three-dimensional-printed porous prosthesis for the joint-sparing reconstruction of the proximal humeral tumorous defect

Efficacy and safety of a 3D-printed arthrodesis prosthesis for reconstruction after resection of the proximal humerus: preliminary outcomes with a minimum 2-year follow-up

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