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Poor clinical outcomes and high rates of dislocation after modular reverse shoulder arthroplasty for proximal humeral oncologic resection

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Abstract

Purpose

The shoulder is the most common site for upper extremity tumors. The aim of the study was to analyze the outcomes and the complications of modular reverse shoulder arthroplasty (RSA) after proximal humerus resection.

Methods

We retrospectively included 15 consecutive patients who underwent a modular MUTARS™ RSA reconstruction after proximal humerus tumour resection between 2017 and 2020. The mean age was 52 years. Their clinical outcomes were assessed using the Constant-Murley score and the MSTS shoulder. Radiological outcomes were assessed based on the presence of loosening, osteolysis, and scapular notching. Complications such as dislocation, oncological recurrence, and infection were assessed. Mean follow-up time was 32.9 months (24 to 45).

Results

The mean adjusted Constant score was 50.7% (min 22, max 81), and the mean MSTS score was 15.6 (min 4, max 26). We had no loosening, osteolysis, or scapular notching on the radiographs at last follow-up. We had a high complication rate of 53%: one infection, one oncological recurrence, and six dislocations (40%), of which five were re-operated.

Conclusion

In our experience, the MUTARS™ Implantcast™ modular RSA has poor functional results and a high rate of dislocation in the case of large proximal humerus resections below the distal insertion of the deltoid.

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Data Availability

Data are fully available upon request.

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Authors and Affiliations

  1. UMR9020-U1277 - CANTHER - Cancer Heterogeneity Plasticity and Resistance to Therapies, Univ. Lille, CHU Lille, Service d’orthopédie 1, 59000, Lille, France

    Thomas Amouyel

  2. Service d’orthopédie 1, Hôpital Roger Salengro, Place de Verdun, Centre Hospitalier Régional Universitaire de Lille, Lille Cedex, France

    Christophe Szymanski, Valentin Rodrigues, Marc Saab & Carlos Maynou

  3. Université de Lille Nord de France, Lille, France

    Valentin Rodrigues, Marc Saab & Carlos Maynou

Authors
  1. Thomas Amouyel
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  2. Christophe Szymanski
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  3. Valentin Rodrigues
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  4. Marc Saab
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  5. Carlos Maynou
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Contributions

TA: methodology, translation, review, editing, revision of the manuscript. CS: original draft preparation, operated all the patients.

VE: formal analysis and investigation

MS: review

CM: review

Corresponding author

Correspondence to Thomas Amouyel.

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Ethical approval

Ethical approval was waived by the local Ethics Committee of the university in view of the retrospective nature of the study and all the procedures being performed were part of the routine care. Institutional review board approval was not required for this retrospective study following MR004 recommendation (MR 2015030320). The database was declared to the CNIL (DEC19-529).

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Informed consent was obtained from all individual participants included in the study.

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The authors declare no competing interests.

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Level of evidence: IV, treatment study.

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Amouyel, T., Szymanski, C., Rodrigues, V. et al. Poor clinical outcomes and high rates of dislocation after modular reverse shoulder arthroplasty for proximal humeral oncologic resection. International Orthopaedics (SICOT) 48, 1331–1339 (2024). https://doi.org/10.1007/s00264-024-06122-7

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  • DOI: https://doi.org/10.1007/s00264-024-06122-7

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