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Henrichs, MP; Liem, D; Gosheger, G; Streitbuerger, A; Nottrott, M; Andreou, D; Hardes, J.
Megaprosthetic replacement of the distal humerus: still a challenge in limb salvage.
J Shoulder Elbow Surg. 2019; 28(5): 908-914. Doi: 10.1016/j.jse.2018.11.050
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Co-authors Med Uni Graz
Andreou Dimosthenis
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Abstract:
BACKGROUND: The distal humerus is a rare location of bone tumors. Because of the complexity of the elbow joint, poor soft-tissue coverage, and proximity of nerves and vessels, resection and endoprosthetic reconstruction are demanding. METHODS: This retrospective study evaluated the clinical results after distal humeral resection and megaprosthetic reconstruction in 12 patients with an average age of 46 years. All patient files were reviewed for clinical information, and postoperative function and patients' contentment were assessed using the Musculoskeletal Tumor Society score. RESULTS: The predominant diagnoses were bone and soft-tissue sarcoma (n = 6), giant cell tumor (n = 2), and renal cell carcinoma metastasis (n = 2). Local recurrence was the reason for secondary amputation in all cases (n = 3). The prosthetic survival rate after surgery was 82% at 2 years and 64% at 5 years. Reconstruction failure was mainly caused by aseptic loosening of the humeral stem, occurring in 27% (n = 3), followed by aseptic loosening of the ulnar stem in 9% (n = 1) and periprosthetic infection in 9% (n = 1). The mean Musculoskeletal Tumor Society score was 24 points (range, 20-30 points). An extension lag of more than 10° was noted in 6 patients (55%). CONCLUSION: Our results suggest that limb salvage with a distal humeral replacement can achieve good functional results in most patients, although the complication rate with special emphasis on the loosening rate of the humeral stem is high. However, limb salvage was not achieved in 27% of patients because of local recurrence.
Find related publications in this database (using NLM MeSH Indexing)
Adult - administration & dosage
Aged - administration & dosage
Amputation - administration & dosage
Arthroplasty, Replacement, Elbow - instrumentation, methods
Bone Neoplasms - surgery
Elbow Joint - surgery
Elbow Prosthesis - administration & dosage
Epiphyses - surgery
Female - administration & dosage
Humans - administration & dosage
Humerus - surgery
Limb Salvage - administration & dosage
Male - administration & dosage
Middle Aged - administration & dosage
Retrospective Studies - administration & dosage
Sarcoma - surgery
Soft Tissue Neoplasms - surgery
Survival Rate - administration & dosage
Treatment Outcome - administration & dosage
Young Adult - administration & dosage

Find related publications in this database (Keywords)
Distal humerus
elbow
bone tumor
megaprosthesis
limb salvage
soft-tissue tumor
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