Treatment of proximal humeral chondrosarcoma with resection and allograft

Mourikis, Anastasios; Mankin, Henry J.; Hornicek, Francis J.; Raskin, Kevin A.

doi:10.1016/j.jse.2006.10.010

Cited by 20 publications

(19 citation statements)

References 33 publications

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“…At a mean followup of 26 months, 30.6% of patients had satisfactory functional results (compared to 74% of patients with proximal femur replacements) [7]. Finally, Mourikis et al [35] concluded all reconstruction approaches to the proximal humerus, resulted in functional problems for the patient (Table 2).…”

Section: Discussionmentioning

confidence: 98%

“…The shoulder is commonly affected by primary and metastatic tumors [37]. Functional deficits and instability are particularly frequent after any type of tumor reconstruction about the shoulder [4,5,11,22,24,25,35,37,44,47,52].…”

Section: Introductionmentioning

confidence: 99%

“…The concept of limb salvage for tumors of the upper extremity is not new [35]. Multiple surgical techniques such as the Tikhoff-Linberg procedure [15,31,32], shortening arthrodeses [2,6], fibular transplants [19], en bloc shoulder allografts [8,41], and metallic implants [9,28,34] have been described to reconstruct the shoulder after tumor resection and avoid the need of forequarter amputations.…”

Section: Introductionmentioning

confidence: 99%

“…Multiple surgical techniques such as the Tikhoff-Linberg procedure [15,31,32], shortening arthrodeses [2,6], fibular transplants [19], en bloc shoulder allografts [8,41], and metallic implants [9,28,34] have been described to reconstruct the shoulder after tumor resection and avoid the need of forequarter amputations. All of these procedures have been associated with joint instability and recurrent dislocations [25], ''flail extremity'' [13], traction neuropraxia [4,5,11], donor site morbidity [2,19,35], or multiple revision surgeries [35]. The development of novel biomaterials has allowed reliable limb reconstructions with endoprostheses and the advances in diagnostic imaging techniques have allowed precise tumor resections preserving neurovascular bundles [40].…”

Section: Introductionmentioning

confidence: 99%

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Proximal and Total Humerus Reconstruction With the Use of an Aortograft Mesh

Marulanda

Henderson

Cheong

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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Background The shoulder is commonly affected by primary and metastatic tumors. Current surgical techniques for complex shoulder reconstruction frequently result in functional deficits and instability. A synthetic mesh used in vascular surgery has the biological properties to provide mechanical constraint and improve stability after tumor related shoulder reconstruction. Questions/purposes We describe (1) surgical technique using a synthetic mesh during humerus reconstructions; (2) functional level defined as shoulder ROM of patients undergoing the procedure; (3) incidence of postoperative dislocation and shoulder instability; and (4) complications associated with the use of the device. Methods We retrospectively reviewed 16 patients with proximal humerus replacements reconstructed with a synthetic mesh from February 2006 to July 2008. Patients were followed clinically and radiographically for a minimum of 13 months (mean, 26 months; range, 13-43 months).Results There were no shoulder dislocations at the latest followup. The mean shoulder flexion was 43°(range, 15°-170°) and mean shoulder abduction of 38 (range, 15°-110°). The mean operative time was 121 minutes (range, 80-170 minutes) and the mean blood loss was 220 mL (range, 50-750 mL).

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Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Proximal and Total Humerus Reconstruction With the Use of an Aortograft Mesh

Marulanda

Henderson

Cheong

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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“…In case of overlapping patient cohorts [36,48,51,52], we included the study reporting on the largest cohort [36,52]. In one of three studies [23,37,43], after correspondence with the author, we included the smaller cohort with a more comprehensive functional outcome [23].…”

Section: Article Selectionmentioning

confidence: 99%

Outcome After Reconstruction of the Proximal Humerus for Tumor Resection: A Systematic Review

Teunis

Nota

Hornicek

et al. 2014

Clinical Orthopaedics &Amp; Related Research

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110

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Background Tumors of the appendicular skeleton commonly affect the proximal humerus, but there is no consensus regarding the best reconstructive technique after proximal humerus resection for tumors of the shoulder. Questions/purposes We wished to perform a systematic review to determine which surgical reconstruction offers the (1) best functional outcome as measured by the Musculoskeletal Tumor Society (MSTS) score, (2) longest construct survival, and (3) lowest complication rate after proximal humerus resection for malignant or aggressive benign tumors of the shoulder. Methods We searched the literature up to June 1, 2013, from MEDLINE, EMBASE, and the Cochrane Library. Only studies reporting results in English, Dutch, or German and with followups of 80% or more of the patients at a minimum of 2 years were included. Twenty-nine studies with 693 patients met our criteria, seven studies (24%) were level of evidence III and the remainder were level IV. Studies reported on reconstruction with prostheses (n = 17), osteoarticular allografts (n = 10), and allograftprosthesis composites (n = 11). Owing to substantial heterogeneity and bias, we narratively report our results. Results Functional scores in prosthesis studies ranged from 61% to 77% (10 studies, 141 patients), from 50% to 78% (eight studies, 84 patients) in osteoarticular graft studies, and from 57% to 91% (10 studies, 141 patients) in allograftprosthesis composite studies. Implant survival ranged from 0.38 to 1.0 in the prosthesis group (341 patients), 0.33 to 1.0 in the osteoarticular allograft group (143 patients), and 0.33 to 1.0 in allograft-prosthesis group (132 patients). Overall complications per patient varied between 0.045 and 0.85 in the prosthesis group, 0 and 1.5 in the osteoarticular graft group, and 0.19 and 0.79 in the prosthesis-composite graft group. We observed a higher fracture rate for osteoarticular allografts, but other specific complication rates were similar. Conclusions Owing to the limitations of our systematic review, we found that allograft-prosthesis composites and prostheses seem to have similar functional outcome and survival rates, and both seem to avoid fractures that are observed with osteoarticular allografts. Further collaboration in the field of surgical oncology, using randomized controlled trials, is required to establish the superiority of any particular treatment. Electronic supplementary material The online version of this article

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