Prosthetic treatment and functional recovery of the shoulder after tumor resection 10 years ago: A case report

Wilde, Lieven De; Plasschaert, Frank

doi:10.1016/j.jse.2004.11.001

Cited by 16 publications

(8 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The restoration of a stable fulcrum using a RSR has been shown in the treatment of tumours of the shoulder. 24,25 Apart from the beneficial effect in the treatment of infection, the radical resection creates space for the reversed prosthesis, which has a hinged instead of a spinning rotation. 26 In contrast to the findings of Cuff et al, 12 we only had two early complications, one haematoma and one dislocation.…”

Section: Discussionmentioning

confidence: 99%

One-stage revision for patients with a chronically infected reverse total shoulder replacement

Beekman

Katusic

Berghs

et al. 2010

The Journal of Bone and Joint Surgery. British volume

122

View full text Add to dashboard Cite

We retrospectively reviewed 11 consecutive patients with an infected reverse shoulder prosthesis. Patients were assessed clinically and radiologically, and standard laboratory tests were carried out. Peroperative samples showed Propionbacterium acnes in seven, coagulase-negative Staphylococcus in five, methicillin-resistant staphylococcus aureus in one and Escherichia coli in one. Two multibacterial and nine monobacterial infections were seen. Post-operatively, patients were treated with intravenous cefazolin for at least three days and in all antibiotic therapy was given for at least three months. Severe pain (3 of 11) or severe limitation of function (3 of 11) are not necessarily seen. A fistula was present in eight, but function was not affected. All but one patient were considered free of infection after one-stage revision at a median follow-up of 24 months, and without antibiotic treatment for a minimum of six months. One patient had a persistent infection despite a second staged revision, but is now free of infection with a spacer. Complications included posterior dislocation in one, haematoma in one and a clavicular fracture in one. At the most recent follow-up the median post-operative Constant-Murley score was 55, 6% adjusted for age, gender and dominance. A one-stage revision arthroplasty reduces the cost and duration of treatment. It is reliable in eradicating infection and good functional outcomes can be achieved.

show abstract

Section: Discussionmentioning

confidence: 99%

One-stage revision for patients with a chronically infected reverse total shoulder replacement

Beekman

Katusic

Berghs

et al. 2010

The Journal of Bone and Joint Surgery. British volume

122

View full text Add to dashboard Cite

show abstract

“…One patient with osteosarcoma had been treated curatively with resection, extracorporeal irradiation, reimplantation, and fixation with an intramedullary nail. Due to failure of this reconstruction, conversion to a reverse shoulder prosthesis was performed 11 years after the primary surgery [13]. A multidisciplinary team decided on further treatment and the need for chemotherapy and/or radiotherapy.…”

Section: Methodsmentioning

confidence: 99%

Does Reverse Shoulder Arthroplasty for Tumors of the Proximal Humerus Reduce Impairment?

Wilde

Boileau

Bracht

2011

Clinical Orthopaedics &Amp; Related Research

Self Cite

108

View full text Add to dashboard Cite

Background Normal function of the upper limb is seldom restored after limb-sparing surgery for tumors of the proximal humerus. The literature suggests superior shoulder function is achieved in the short term with reverse total shoulder arthroplasty compared to other techniques when performed for conditions with rotator cuff deficiency. It is unclear whether this superiority is maintained when reverse total shoulder arthroplasty is performed for tumors. Questions/purposes When performed for tumors, we determined whether reverse total shoulder arthroplasty restores function and improves motion, the complications associated with the surgery, and whether reverse total shoulder arthroplasty with autologous grafting is associated with bone resorption. Patients and MethodsWe retrospectively reviewed 14 patients who had undergone reverse total shoulder arthroplasty for tumors of the proximal humerus. Four patients died, leaving nine patients for review. The surviving patients were evaluated clinically and radiographically. The minimum followup was 0.6 years (mean, 7.7 years; range, 0.6-12 years). Results At last followup, mean active abduction was 157°a nd mean functional Constant-Murley score was 76%. One patient had a deep infection and one developed a loose prosthesis; both were treated with single-stage exchange. At last followup, both patients had reasonable function without evidence of infection or loosening. Radiographic graft resorption was seen in all but one patient. Conclusions Our observations suggest, at medium-term followup, reverse total shoulder arthroplasty is a reasonable option for tumors of the proximal humerus. It has low morbidity, restores a mean active abduction of 157°, and limits the impairment of activities of daily living.

show abstract

“…The use of a tumor endoprosthesis has been reported. 8,[12][13][14][15][16][17] though these studies largely focus on patients having undergone tumor resection. The purpose of this study was to evaluate the outcomes of RSA using a segmental reconstruction prosthesis to address significant proximal humeral bone loss following nonmalignant conditions (ie, malunions, nonunions, or failed arthroplasty) as well as after tumor resection.…”

Section: Introductionmentioning

confidence: 99%

Reverse Shoulder Arthroplasty With Proximal Humeral Replacement for the Management of Massive Proximal Humeral Bone Loss

Shukla

Lee

Mangold

et al. 2018

Journal of Shoulder and Elbow Arthroplasty

View full text Add to dashboard Cite

Background: Substantial proximal humeral bone loss may compromise reverse shoulder arthroplasty secondary to limited implant support, insufficient soft tissue tension due to shortening, lack of attachment sites for the posterosuperior cuff when present, and lack of lateral offset of the deltoid. In these circumstances, use of a proximal humeral replacement may be considered. Patients/Methods: Between 2012 and 2014, 34 consecutive reverse shoulder arthroplasties were performed using a proximal humeral replacement system. The indications were failed shoulder arthroplasty (15), oncology reconstruction (9), humeral malunion/nonunion (7), prior resection arthroplasty (2), and intraoperative fracture (1). All patients were included in the survival analysis. Twenty-two patients with minimum 2-year follow-up were included in analysis of clinical results. Results: Among the cohort of 34 patients, there were 8 additional reoperations: humeral loosening (3), periprosthetic fracture (2), irrigation and debridement (2), and glenoid loosening (1). Humeral component loosening occurred exclusively in patients undergoing revision shoulder arthroplasty. The 4 patients had an average 3.75 prior procedures before the proximal humeral replacement. Two of the revisions were from cemented to uncemented stems. Among the 23 patients with minimum 2-year follow-up, there was significant improvement in pain scores (4.1 vs 0.6), forward elevation (31 vs 109) degrees, and 81% were satisfied. Conclusion: Use of a proximal humeral replacement when performing a reverse shoulder arthroplasty in the complex setting of substantial proximal humerus bone loss provides good clinical results and a particularly low dislocation rate. However, the rate of loosening of the humeral component in the revision setting suggests that proximal humeral replacement components should be cemented when revising a previously cemented stem. IRB: 16-006966.

show abstract

Prosthetic treatment and functional recovery of the shoulder after tumor resection 10 years ago: A case report

Cited by 16 publications

References 23 publications

One-stage revision for patients with a chronically infected reverse total shoulder replacement

One-stage revision for patients with a chronically infected reverse total shoulder replacement

Does Reverse Shoulder Arthroplasty for Tumors of the Proximal Humerus Reduce Impairment?

Reverse Shoulder Arthroplasty With Proximal Humeral Replacement for the Management of Massive Proximal Humeral Bone Loss

Contact Info

Product

Resources

About