Early Outcomes of Reverse Shoulder Arthroplasty for Tumors of the Humerus


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Abstract

At present in 90% of patients with malignant tumors of long bones and large joints the organ-saving intervention - oncologic joint replacement can be performed. The risk of complications after such operations on the upper extremity is low however the adequate functional results can not be achieved. The analysis and evaluation of oncologic and functional results after application of anatomic (group 1, n=28) and reverse (group 2, n=14) shoulder prostheses in patients with proximal humerus tumors was performed. Mean age of patients made up 32±4 and 38±3 years in the 1st and 2nd groups, respectively. Primary bone tumors were diagnosed in 19 (68%) patients from the 1st and 12 (86%) patients from the 2nd group. Mean follow up period was 42 months. Progression of the disease at terms from 6 to 14 months was observed in 4 patients with primary malignant bone tumors. Functional result by MSTS scale was 60-80% in 3, 40-60% in 6 and under 40% in 19 patients from the 1st group. In 2nd group functional result ranged from 80 to 100% in 6, from 60 to 80% in 6 and from 40 to 60% in 2 patients. Application of modular reverse prosthesis for the treatment of patients with proximal humerus tumors is a perspective technique as it enables to increase functional result and social adaptation of patients significantly.

About the authors

V. Yu Karpenko

P. A. Gertsen Moscow Research Center, Moscow, Russia

канд. мед. наук, старший науч. сотр. группы опухолей костей и мягких тканей, отдела хирургического лечения опухолей центральной нервной и костно-мышечной систем

V. A Derzhavin

P. A. Gertsen Moscow Research Center, Moscow, Russia

Email: osteosa@yandex.ru
кандидат мед. наук, научные сотрудник группы опухолей костей и мягких тканей, отдела хирургического лечения опухолей центральной нервной и костно-мышечной систем; Тел.: +7 (926) 389-31-17. 127562, Москва, 2-й Боткинский пр., д. 3

A. V Bukharov

P. A. Gertsen Moscow Research Center, Moscow, Russia

кандидат мед. наук, научные сотрудник группы опухолей костей и мягких тканей, отдела хирургического лечения опухолей центральной нервной и костно-мышечной систем

T. V Danilova

P. A. Gertsen Moscow Research Center, Moscow, Russia

канд. биол. наук, ученый секретарь

M. S Andreev

P. A. Gertsen Moscow Research Center, Moscow, Russia

очный аспирант группы опухолей костей и мягких тканей, отдела хирургического лечения опухолей центральной нервной и костно-мышечной систем

References

  1. Timothy A. Orthopaedic surgery essentials. Oncology and Basic Science. Lippincot Williams & Wilkins; 2008: 3, 63.
  2. Gosheger G., Gebert C., Ahrens H., Streitbuerger A., Winkelmann W., Hardes J. Endoprosthetic reconstruction in 250 patients with sarcoma. Clin. Orthop. Relat. Res. 2006; 450: 164-71.
  3. Некачалов В.В. Патология костей и суставов: Руководство. СПб: Сотис; 2000.
  4. Aliev M.D., Teplyakov V., Sicheva L., Karpenko V. Modern orthopaedical treatment of metastatic lesion of long bones. 17th Annual Meeting of the EMSOS. Oslo, Norway; 2004: 46
  5. Asavamongkolkul A., Eckardt J.J., Eilber F.R., Dorey F.J., Ward W.G., Kelly C.M. et al. Endoprosthetic reconstruction for malignant upper extremity tumors. Clin. Orthop. Relat. Res. 1999; (360): 207-20.
  6. Карпенко В.Ю. Хирургическое лечение метастатического поражения длинных трубчатых костей как этап комбинированной терапии: Дис. … канд. мед. наук. М.; 2005: 126-7.
  7. Berruti A., Dogliotti L., Gorzegno G., Torta M., Tampellini M., Tucci M. et al. Differential patterns of bone turnover in relation to bone pain and disease extent in bone in cancer patients with skeletal metastases. Clin. Chem. 1999; 45 (Pt 8): 1240-7.
  8. Iwamoto Y. Diagnosis and Treatment of Ewing’s Sarcoma. Jpn J. Clin. Oncol. 2007; 37 (2): 79-89.
  9. Rougraff B.T., Simon M.A., Kneisl J.S., Greenberg D.B., Mankin H.J. Limb salvage compared with amputation for osteosarcoma of the distal end of the femur. A long-term oncological, functional, and quality-of-life study. J. Bone Joint Surg. Am. 1994; 76: 649-56.
  10. Mittermayer F., Krepler P., Dominkus M., Schwameis E., Sluga M., Heinzl H., Kotz R. Long-term follow up of uncemented tumor endoprostheses for the lower extremity. Clin. Orthop. Relat. Res. 2001; 388: 167-77.
  11. Sluga M., Windhager R., Lang S., Heinzl H., Bielack S., Kotz R. Local and systemic control after ablative and limb sparing surgery in patients with osteosarcoma. Clin. Orthop. Relat. Res. 1999; 358: 120-7.
  12. Gosheger G., Goetze C., Hardes J., Joosten U, Winkelmann W, von Eiff C. The influence of the alloy of megaprostheses on infection rate. J. Arthroplasty. 2008; 23 (6): 916-920
  13. Hardes J., Ahrens H., Gebert C., Streitbuerger A., Buerger H., Erren M. et. al. Lack of toxicological sideeffects in silver-coated megaprostheses in humans. Biomaterials. 2008; 28 (18): 2869-75.
  14. Hardes J., von Eiff C., Streitbuerger A., Balke M., Budny T., Henrichs M.P. et al. Reduction of periprosthetic infection with silver-coated megaprostheses in patients with bone sarcoma. J. Surg. Oncol. 2010; 101 (5): 389-95.
  15. Балберкин А.В., Шавырин Д.А., Карпов В.Н. Клиническое обоснование конструкции модульной эндосистемы коленного сустава, дистального отдела бедренной кости и проксимального отдела большеберцовой кости. Саркомы костей, мягких тканей и опухоли кожи. 2011; 4: 12-20.
  16. Dieckmann R., Liem D., Gosheger G., Henrichs M.P. Evaluation of a reconstruction reverse shoulder for tumour surgery and tribological comparision with an anatomical shoulder arthroplasty. Int. Orthop. (SICOT); 2013; 37: 451-6.
  17. Gupta G.R., Yasko A.W., Lewis V.O., Cannon C.P., Raymond A.K., Patel S., Lin P.P. Risk of local recurrence after deltoid-sparing resection for osteosarcoma of the proximal humerus. Cancer. 2009; 115: 3767-73.
  18. Gosheger G., Hardes J., Ahrens H., Gebert C., Winkelmann W. Endoprosthetic replacement of the humerus combined with trapezius and latissimus dorsi transfer: a report of three patients. Arch. Orthop. Trauma Surg. 2005; 125: 62-5.
  19. Flury M.P., Frey P., Goldhahn J., Schwyzer H.K., Simmen B.R. Reverse shoulder arthroplasty as a salvage procedure for failed conventional shoulder replacement due to cuff failure-midterm results. Int. Orthop. 2011; 35 (1): 53-60.
  20. Boileau P., Watkinson D., Hatzidakis A.M., Hovorka I. Neer Award 2005: The Grammont reverse shoulder prosthesis: results in cuff tear arthritis, fracture sequelae, and revision arthroplasty. J. Shoulder Elbow Surg. 2006; 15 (5): 527-40.
  21. Canale T.S., Beaty J.H. Campbell's Operative Orthopaedics. 12th ed. Elsevier; 2012: 2004-67.
  22. Enneking W.F., Dunham W., Gebhardt M.C., Malawеr M., Pritchard D.J. A system for the functional evaluation of reconstructive procedures after surgical treatment of tumours of the musculoskeletal system. Clin. Orthop. Relat. Res. 1993; 286:241-6.
  23. Мачак Г.Н. Современные возможности и перспективы комбинированного лечения остеосаркомы: Автореф. дис. … д-ра мед. наук. М.; 2007: 43-5.
  24. Wodajo F.M., Bickels J., Wittig J., Malawer M. Complex reconstruction in the management of extremity sarcomas. Curr. Opin. Oncol. 2003; 15: 304-312.
  25. Raiss P., Kinkel S., Sauter U., Bruckner T., Lehner B. Replacement of the proximal humerus with MUTARS tumor endoprostheses. EJSO. 2010; 36: 371-7.

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