Shoulder Surgery for Bone Tumors

Abstract

The proximal humerus is a common location for bone tumors. Those can affect patients of different ages and can be of benign or malignant nature. For bone sarcomas is the 3rd most common location and is a frequent site of spread in non-axial metastatic disease. In pediatric patients is frequent to encounter benign bone tumors in this location but also osteosarcomas and Ewing’s sarcomas. Careful assessment of the patients by a surgeon with the appropriate training is paramount. Shoulder reconstruction for patients with bone tumors encompasses a diverse group of patients, diagnoses and surgical options. While most patients with primary bone tumors may be of a younger age and more involved in sport activities, those with metastatic disease oftentimes are associated with an older age, worse preoperative function and worse prognosis due to the primary disease. The surgeon must weigh in all factors that need to be taken into consideration in the treatment decision-making plan. Currently, with new advances in oncology treatments patients may benefit from longer survivals times than in the past, thus restoring the patient’s function and quality of life is essential.

Reconstruction with a double-constrained implant design after complex shoulder extra-articular resection

“…Reconstructing the proximal humerus after tumor resection poses a technical challenge for oncology orthopedists, especially in cases of extra-articular resection and for young patients with a good oncologic prognosis. Several alternatives are currently available, all with specific indications, advantages, and disadvantages [ 25 , 26 ]. Some advocate the use of biologic options for younger patients, with more healing potential, whilst indicating endoprosthetic reconstruction for older patients with possibly lower functional requirements [ 27 ].…”