Allograft-prosthetic composite reverse total shoulder arthroplasty for reconstruction of proximal humerus tumor resections
Background Proximal humerus reconstructions after resection of tumors are challenging. Early success of the reverse shoulder arthroplasty for reconstructions has recently been reported. The reverse allograft-prosthetic composite offers the advantage of improved glenohumeral stability compared with h...
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| Veröffentlicht in: | Journal of shoulder and elbow surgery 2016-01, Vol.25 (1), p.45-54 |
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| container_title | Journal of shoulder and elbow surgery |
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| creator | King, Joseph J., MD Nystrom, Lukas M., MD Reimer, Nickolas B., MD Gibbs, C. Parker, MD Scarborough, Mark T., MD Wright, Thomas W., MD |
| description | Background Proximal humerus reconstructions after resection of tumors are challenging. Early success of the reverse shoulder arthroplasty for reconstructions has recently been reported. The reverse allograft-prosthetic composite offers the advantage of improved glenohumeral stability compared with hemiarthroplasty for proximal humeral reconstructions as it uses the deltoid for stability. Methods This article describes the technique for treating proximal humeral tumors, including preoperative planning, biopsy principles, resection pearls, soft tissue tensioning, and specifics about reconstruction using the reverse allograft-prosthetic composite. Two cases are presented along with the functional outcomes with use of this technique. Biomechanical considerations during reconstruction are reviewed, including techniques to improve the deltoid compression force. Results Reported instability rates are less with reverse shoulder arthroplasty reconstruction as opposed to hemiarthroplasty or total shoulder arthroplasty reconstructions of tumor resections. Reported functional outcomes are promising for the reverse allograft-prosthetic composite reconstructions, although complications are reported. Conclusion Reverse allograft-prosthetic composites are a promising option for proximal humeral reconstructions, although nonunion of the allograft–host bone junction continues to be a challenge for this technique. |
| doi_str_mv | 10.1016/j.jse.2015.06.021 |
| format | Article |
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Parker, MD ; Scarborough, Mark T., MD ; Wright, Thomas W., MD</creator><creatorcontrib>King, Joseph J., MD ; Nystrom, Lukas M., MD ; Reimer, Nickolas B., MD ; Gibbs, C. Parker, MD ; Scarborough, Mark T., MD ; Wright, Thomas W., MD</creatorcontrib><description>Background Proximal humerus reconstructions after resection of tumors are challenging. Early success of the reverse shoulder arthroplasty for reconstructions has recently been reported. The reverse allograft-prosthetic composite offers the advantage of improved glenohumeral stability compared with hemiarthroplasty for proximal humeral reconstructions as it uses the deltoid for stability. Methods This article describes the technique for treating proximal humeral tumors, including preoperative planning, biopsy principles, resection pearls, soft tissue tensioning, and specifics about reconstruction using the reverse allograft-prosthetic composite. Two cases are presented along with the functional outcomes with use of this technique. Biomechanical considerations during reconstruction are reviewed, including techniques to improve the deltoid compression force. Results Reported instability rates are less with reverse shoulder arthroplasty reconstruction as opposed to hemiarthroplasty or total shoulder arthroplasty reconstructions of tumor resections. Reported functional outcomes are promising for the reverse allograft-prosthetic composite reconstructions, although complications are reported. Conclusion Reverse allograft-prosthetic composites are a promising option for proximal humeral reconstructions, although nonunion of the allograft–host bone junction continues to be a challenge for this technique.</description><identifier>ISSN: 1058-2746</identifier><identifier>EISSN: 1532-6500</identifier><identifier>DOI: 10.1016/j.jse.2015.06.021</identifier><identifier>PMID: 26256013</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adult ; allograft-prosthetic composite ; Allografts ; Arthroplasty, Replacement - instrumentation ; Arthroplasty, Replacement - methods ; Biomechanical Phenomena ; Bone Neoplasms - surgery ; Bone Transplantation ; Chondrosarcoma - surgery ; Deltoid Muscle - surgery ; Female ; glenohumeral joint ; Humans ; Humeral Head - surgery ; Joint Prosthesis ; Male ; Orthopedics ; Patient Care Planning ; Prosthesis Design ; proximal humerus reconstruction ; Reverse total shoulder arthroplasty ; Shoulder Joint - physiopathology ; Shoulder Joint - surgery ; tumor resections ; Young Adult</subject><ispartof>Journal of shoulder and elbow surgery, 2016-01, Vol.25 (1), p.45-54</ispartof><rights>Journal of Shoulder and Elbow Surgery Board of Trustees</rights><rights>2016 Journal of Shoulder and Elbow Surgery Board of Trustees</rights><rights>Copyright © 2016 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c478t-3ad0a47b0379400bb1e64484afff4f4e94bb29861674c6dc64ea58d5a5568eb93</citedby><cites>FETCH-LOGICAL-c478t-3ad0a47b0379400bb1e64484afff4f4e94bb29861674c6dc64ea58d5a5568eb93</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S1058274615003419$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26256013$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>King, Joseph J., MD</creatorcontrib><creatorcontrib>Nystrom, Lukas M., MD</creatorcontrib><creatorcontrib>Reimer, Nickolas B., MD</creatorcontrib><creatorcontrib>Gibbs, C. Parker, MD</creatorcontrib><creatorcontrib>Scarborough, Mark T., MD</creatorcontrib><creatorcontrib>Wright, Thomas W., MD</creatorcontrib><title>Allograft-prosthetic composite reverse total shoulder arthroplasty for reconstruction of proximal humerus tumor resections</title><title>Journal of shoulder and elbow surgery</title><addtitle>J Shoulder Elbow Surg</addtitle><description>Background Proximal humerus reconstructions after resection of tumors are challenging. Early success of the reverse shoulder arthroplasty for reconstructions has recently been reported. The reverse allograft-prosthetic composite offers the advantage of improved glenohumeral stability compared with hemiarthroplasty for proximal humeral reconstructions as it uses the deltoid for stability. Methods This article describes the technique for treating proximal humeral tumors, including preoperative planning, biopsy principles, resection pearls, soft tissue tensioning, and specifics about reconstruction using the reverse allograft-prosthetic composite. Two cases are presented along with the functional outcomes with use of this technique. Biomechanical considerations during reconstruction are reviewed, including techniques to improve the deltoid compression force. Results Reported instability rates are less with reverse shoulder arthroplasty reconstruction as opposed to hemiarthroplasty or total shoulder arthroplasty reconstructions of tumor resections. Reported functional outcomes are promising for the reverse allograft-prosthetic composite reconstructions, although complications are reported. Conclusion Reverse allograft-prosthetic composites are a promising option for proximal humeral reconstructions, although nonunion of the allograft–host bone junction continues to be a challenge for this technique.</description><subject>Adult</subject><subject>allograft-prosthetic composite</subject><subject>Allografts</subject><subject>Arthroplasty, Replacement - instrumentation</subject><subject>Arthroplasty, Replacement - methods</subject><subject>Biomechanical Phenomena</subject><subject>Bone Neoplasms - surgery</subject><subject>Bone Transplantation</subject><subject>Chondrosarcoma - surgery</subject><subject>Deltoid Muscle - surgery</subject><subject>Female</subject><subject>glenohumeral joint</subject><subject>Humans</subject><subject>Humeral Head - surgery</subject><subject>Joint Prosthesis</subject><subject>Male</subject><subject>Orthopedics</subject><subject>Patient Care Planning</subject><subject>Prosthesis Design</subject><subject>proximal humerus reconstruction</subject><subject>Reverse total shoulder arthroplasty</subject><subject>Shoulder Joint - physiopathology</subject><subject>Shoulder Joint - surgery</subject><subject>tumor resections</subject><subject>Young Adult</subject><issn>1058-2746</issn><issn>1532-6500</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kj2P1DAQhiME4j7gB9CglDQJY8d2EiEhnU7AIZ1EAdSW40xYBydePM6J5dfjvT0oKKjs4nlfjZ9xUbxgUDNg6vVcz4Q1ByZrUDVw9qg4Z7LhlZIAj_MdZFfxVqiz4oJoBoBeAH9anHHFpQLWnBe_rrwP36KZUrWPgdIOk7OlDcs-kEtYRrzDSFimkIwvaRc2P2IsTUy7GPbeUDqUU4iZs2GlFDebXFjLMJW57qdbcmi3LRg3KtO23IOE9ww9K55MxhM-fzgvi6_v3325vqluP334eH11W1nRdqlqzAhGtAM0bZ4ehoGhEqITZpomMQnsxTDwvlNMtcKq0SqBRnajNFKqDoe-uSxenXrzRD82pKQXRxa9NyuGjTRrJWO9FA3PKDuhNrugiJPex_yGeNAM9FG5nnVWro_KNSidlefMy4f6bVhw_Jv44zgDb04A5kfeOYyarMPV4uiytaTH4P5b__aftPVuddb473hAmsMW12xPM01cg_583Plx5Sx_gUawvvkNrJ-qVg</recordid><startdate>20160101</startdate><enddate>20160101</enddate><creator>King, Joseph J., MD</creator><creator>Nystrom, Lukas M., MD</creator><creator>Reimer, Nickolas B., MD</creator><creator>Gibbs, C. Parker, MD</creator><creator>Scarborough, Mark T., MD</creator><creator>Wright, Thomas W., MD</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20160101</creationdate><title>Allograft-prosthetic composite reverse total shoulder arthroplasty for reconstruction of proximal humerus tumor resections</title><author>King, Joseph J., MD ; Nystrom, Lukas M., MD ; Reimer, Nickolas B., MD ; Gibbs, C. Parker, MD ; Scarborough, Mark T., MD ; Wright, Thomas W., MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c478t-3ad0a47b0379400bb1e64484afff4f4e94bb29861674c6dc64ea58d5a5568eb93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adult</topic><topic>allograft-prosthetic composite</topic><topic>Allografts</topic><topic>Arthroplasty, Replacement - instrumentation</topic><topic>Arthroplasty, Replacement - methods</topic><topic>Biomechanical Phenomena</topic><topic>Bone Neoplasms - surgery</topic><topic>Bone Transplantation</topic><topic>Chondrosarcoma - surgery</topic><topic>Deltoid Muscle - surgery</topic><topic>Female</topic><topic>glenohumeral joint</topic><topic>Humans</topic><topic>Humeral Head - surgery</topic><topic>Joint Prosthesis</topic><topic>Male</topic><topic>Orthopedics</topic><topic>Patient Care Planning</topic><topic>Prosthesis Design</topic><topic>proximal humerus reconstruction</topic><topic>Reverse total shoulder arthroplasty</topic><topic>Shoulder Joint - physiopathology</topic><topic>Shoulder Joint - surgery</topic><topic>tumor resections</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>King, Joseph J., MD</creatorcontrib><creatorcontrib>Nystrom, Lukas M., MD</creatorcontrib><creatorcontrib>Reimer, Nickolas B., MD</creatorcontrib><creatorcontrib>Gibbs, C. Parker, MD</creatorcontrib><creatorcontrib>Scarborough, Mark T., MD</creatorcontrib><creatorcontrib>Wright, Thomas W., MD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of shoulder and elbow surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>King, Joseph J., MD</au><au>Nystrom, Lukas M., MD</au><au>Reimer, Nickolas B., MD</au><au>Gibbs, C. Parker, MD</au><au>Scarborough, Mark T., MD</au><au>Wright, Thomas W., MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Allograft-prosthetic composite reverse total shoulder arthroplasty for reconstruction of proximal humerus tumor resections</atitle><jtitle>Journal of shoulder and elbow surgery</jtitle><addtitle>J Shoulder Elbow Surg</addtitle><date>2016-01-01</date><risdate>2016</risdate><volume>25</volume><issue>1</issue><spage>45</spage><epage>54</epage><pages>45-54</pages><issn>1058-2746</issn><eissn>1532-6500</eissn><abstract>Background Proximal humerus reconstructions after resection of tumors are challenging. Early success of the reverse shoulder arthroplasty for reconstructions has recently been reported. The reverse allograft-prosthetic composite offers the advantage of improved glenohumeral stability compared with hemiarthroplasty for proximal humeral reconstructions as it uses the deltoid for stability. Methods This article describes the technique for treating proximal humeral tumors, including preoperative planning, biopsy principles, resection pearls, soft tissue tensioning, and specifics about reconstruction using the reverse allograft-prosthetic composite. Two cases are presented along with the functional outcomes with use of this technique. Biomechanical considerations during reconstruction are reviewed, including techniques to improve the deltoid compression force. Results Reported instability rates are less with reverse shoulder arthroplasty reconstruction as opposed to hemiarthroplasty or total shoulder arthroplasty reconstructions of tumor resections. Reported functional outcomes are promising for the reverse allograft-prosthetic composite reconstructions, although complications are reported. Conclusion Reverse allograft-prosthetic composites are a promising option for proximal humeral reconstructions, although nonunion of the allograft–host bone junction continues to be a challenge for this technique.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>26256013</pmid><doi>10.1016/j.jse.2015.06.021</doi><tpages>10</tpages></addata></record> |
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| subjects | Adult allograft-prosthetic composite Allografts Arthroplasty, Replacement - instrumentation Arthroplasty, Replacement - methods Biomechanical Phenomena Bone Neoplasms - surgery Bone Transplantation Chondrosarcoma - surgery Deltoid Muscle - surgery Female glenohumeral joint Humans Humeral Head - surgery Joint Prosthesis Male Orthopedics Patient Care Planning Prosthesis Design proximal humerus reconstruction Reverse total shoulder arthroplasty Shoulder Joint - physiopathology Shoulder Joint - surgery tumor resections Young Adult |
| title | Allograft-prosthetic composite reverse total shoulder arthroplasty for reconstruction of proximal humerus tumor resections |
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