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Journal of Bone and Joint Surgery - British Volume, Vol 85-B, Issue 5, 717-722.
doi: 10.1302/0301-620X.85B5.13838  
Copyright © 2003 by British Editorial Society of Bone and Joint Surgery
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Endoprosthetic replacement of the proximal humerus

LONG-TERM RESULTS

D. Kumar, FRCS MSc (Trauma), Registrar in Trauma and Orthopaedics; R. J. Grimer, FRCS, Consultant Orthopaedic Oncologist; A. Abudu, FRCS (Orth), Consultant Orthopaedic Oncologist; S. R. Carter, FRCS, Consultant Orthopaedic Oncologist; and R. M. Tillman, FRCS, Consultant Orthopaedic Oncologist

Oncology Service, Royal Orthopaedic Hospital, Bristol Road South, Northfield, Birmingham B31 2AP, UK.

Correspondence should be sent to Mr D. Kumar at 111 Wellman Croft, Selly Oak, Birmingham B29 6NS, UK.

We studied 100 patients who had undergone endoprosthetic replacement of the proximal humerus between 1976 and 1998. The outcome was assessed with regard to the survivorship of the patients, the salvaged limbs and the prostheses. Function was determined in the 47 surviving patients, of whom 30 were assessed using the Musculo-Skeletal Tumour Society (MSTS) rating scale and 38 completed the Toronto Extremity Salvage Score (TESS) questionnaire.

The median age of the patients was 34 years (10 to 80). The mean follow-up period for surviving patients was nine years (2 to 20). The mean MSTS score at follow-up was 79% and the mean TESS score was 72%. The length of bone which was resected influenced the functional outcome. Abduction of the shoulder was to 45° in most patients. The overall survival was 42% at ten years and that of the limb without amputation 93%. The survival of the prostheses using mechanical failure as the endpoint was 86.5% at 20 years.

Endoprosthetic replacement of the proximal humerus is a predictable procedure providing reasonable function of the arm with a low rate of complications at long-term follow-up.




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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General