, Volume 468, Issue 11, pp 2896-2903
Date: 22 Jun 2010

Proximal and Total Humerus Reconstruction With the Use of an Aortograft Mesh

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Abstract

Background

The shoulder is commonly affected by primary and metastatic tumors. Current surgical techniques for complex shoulder reconstruction frequently result in functional deficits and instability. A synthetic mesh used in vascular surgery has the biological properties to provide mechanical constraint and improve stability after tumor related shoulder reconstruction.

Questions/purposes

We describe (1) surgical technique using a synthetic mesh during humerus reconstructions; (2) functional level defined as shoulder ROM of patients undergoing the procedure; (3) incidence of postoperative dislocation and shoulder instability; and (4) complications associated with the use of the device.

Methods

We retrospectively reviewed 16 patients with proximal humerus replacements reconstructed with a synthetic mesh from February 2006 to July 2008. Patients were followed clinically and radiographically for a minimum of 13 months (mean, 26 months; range, 13–43 months).

Results

There were no shoulder dislocations at the latest followup. The mean shoulder flexion was 43° (range, 15°–170°) and mean shoulder abduction of 38 (range, 15°–110°). The mean operative time was 121 minutes (range, 80–170 minutes) and the mean blood loss was 220 mL (range, 50–750 mL). One patient had a superficial wound infection and none a deep infection requiring removal of the graft or prosthesis.

Conclusions

The data suggest the use of a synthetic vascular mesh for proximal humerus reconstruction may reduce dislocations and facilitate soft tissue attachment and reconstruction after tumor resection.

Level of Evidence

Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.
Each author certifies that his or her institution approved the human protocol for this investigation and all investigations were conducted in conformity with ethical principles of research.
This work was performed at the Moffitt Cancer Center.