The Use of Cement in Osteoarticular Allografts for Proximal Humeral Bone Tumors

Proximal Humerus Reconstructions for Tumors

“…Although not always symptomatic, humeral head collapse causing declining OA reconstruction function with time also has been noted [13,24,25]. DeGroot et al [7] proposed filling grafts with cement for fracture prevention, but fractures still occurred in 18% of patients in their series, and this technique may complicate subsequent revision surgery. Although dislocation rates as much as 50% have been reported for OA reconstructions [13], our series had generally favorable joint stability after OA and APC reconstruction.…”

“…The most commonly used reconstructive techniques after proximal humeral resection include osteoarticular allografts [6,7,12,13,24,25], allograft-or autograftprosthesis composites [3,5,15], and endoprosthetic reconstruction [1, 4, 6, 8, 17, 18, 20, 24-26, 28, 31]. Alternative techniques include allograft arthrodesis, Tikhoff-Linberg resection and modifications, claviculo pro humero, vascularized fibula transfers, and concomitant scapular replacement [21,22,25].…”

Long-term Results for Limb Salvage with Osteoarticular Allograft Reconstruction

“…DeGroot et al [4] described a reduced rate of fractures in cementfilled allografts of the proximal humerus. They also reported decreased severity of subchondral fractures and subsequent articular collapse in cement-filled allografts [4]. Therefore, cement may even improve the incidence of DJD in allograft reconstruction.…”

Management of infection following reconstruction in bone tumors

“…The recommended treatment includes administration of antibiotics for a prolonged period intravenously for 2-14 days and orally for up to 16 weeks. 89,90 Empirically, antibiotic 85,90 with antibiotics before implantation, achieving high local concentrations of antibiotic during the initial elution, help in prevention and treatment of infection. Use of intramedullary antibiotic bone cement 91 also helps in infection prevention and outcome.…”