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. 2022 May 21;23(1):484.
doi: 10.1186/s12891-022-05432-4.

Outcomes of modular endoprosthesis reconstruction versus cement spacer reconstruction following resection of proximal humeral tumors

Walid Atef Ebeid  1 , Sherif Eldaw  2 , Ismail Tawfeek Badr  3 , Mohamed Kamal Mesregah  4 , Bahaa Zakarya Hasan  3
Affiliations

Outcomes of modular endoprosthesis reconstruction versus cement spacer reconstruction following resection of proximal humeral tumors

Walid Atef Ebeid et al. BMC Musculoskelet Disord. .

Abstract

Background: There is no agreement about the best reconstructive option following resection of proximal humerus tumors. The purpose of this study was to compare the functional outcomes of endoprosthesis reconstruction versus nail cement spacer reconstruction after wide resection of proximal humeral tumors.

Methods: This retrospective comparative study included 58 patients with proximal humerus tumors who had undergone tumor resection and reconstruction with modular endoprosthesis (humeral hemiarthroplasties) or cement spacer. Medical records were reviewed for the epidemiological, clinical, radiological, and operative data. Lung metastasis, local recurrence, and complication were also reviewed. The functional outcome was evaluated using the Musculoskeletal Tumor Society scoring (MSTS) system.

Results: Nineteen patients with a mean age of 33.4 ± 17.5 years underwent reconstruction by modular endoprosthesis, and 39 patients with a mean age of 24.6 ± 14.3 years underwent reconstruction by cement spacer. The mean MSTS score was 24.8 ± 1.1 in the endoprosthesis group and 23.9 ± 1.4 in the spacer group, P = 0.018. Complications were reported in 5 (26.3%) patients in the endoprosthesis group and 11 (28.2%) patients in the spacer group, P = 0.879. There were no statistically significant differences in the functional outcomes in both patient groups with or without axillary or deltoid resection.

Conclusions: Both endoprostheses and cement spacers are durable reconstructions with almost equal functional outcomes with no added advantage of the expensive endoprosthesis.

Keywords: Cement spacer; Limb salvage; Modular endoprosthesis; Outcomes; Proximal humeral tumors; Reconstruction.

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Conflict of interest statement

All authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
A 24-year-old female patient with osteosarcoma of the proximal humerus had undergone tumor resection and reconstruction with endoprosthesis. A Plain X-ray of the shoulder, anteroposterior view. B MRI axial view. C Postoperative X-rays, anteroposterior and lateral views. D Two-year follow-up X-rays, anteroposterior view
Fig. 2
Fig. 2
A 22-year-old female patient with giant cell tumor of the proximal humerus had undergone tumor resection and reconstruction with cement spacer. A Plain X-ray of the shoulder, anteroposterior view. B MRI sagittal view. C Postoperative X-rays, anteroposterior and lateral views. D Two-year follow-up X-rays, anteroposterior and lateral views
See this image and copyright information in PMC

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