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Composite reverse shoulder arthroplasty can provide good function and quality of life in cases of malignant tumour of the proximal humerus

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Abstract

Purpose

Management of proximal humeral tumours remains a surgical challenge. No study to date has assessed the quality of life scores following the composite reverse shoulder arthroplasty for this indication. We, therefore, evaluated function and quality of life following reconstruction with allograft for malignant tumour of the humerus.

Methods

A series of six cases of humeral tumour treated by a single surgeon in a single centre was reviewed after a mean follow-up of 5.9 years. The tumours included two chondrosarcomas, one plasmocytoma and three metastases. Resection involved bone epiphysis, metaphysis and diaphysis in five cases (S3S4S5A) and epiphysis and metaphysis in one case (S3S4A). For reconstruction, an allograft composite reverse shoulder arthroplasty was used in all the cases. Outcomes were assessed with range of motion, the QuickDash score and the Short Form 12 (SF-12) Health Survey. Radiographs assessed osseointegration and complications.

Results

At the final follow-up, the mean shoulder range of motion were respectively 95°, 57° and 11° for forward flexion, abduction and external rotation. Mean QuickDASH score improved from 28 to 41 and VAS-pain scores improved from 5.1 to 2.3. The post-operative MSTS score was 73% and the Constant score was 46.1/100. The SF-12 PCS and MCS scores were also improved, respectively from 44.4 and 39.7 to 45.5 and 56.1. The mean satisfaction score was 8.1/10.

Conclusions

Composite reverse shoulder arthroplasty is a viable alternative for reconstruction after resection of malignant humeral tumour. Although total tumour resection was the most important objective, the functional and quality of life scores were satisfactory.

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Authors and Affiliations

  1. Hand and Upper Extremity Surgery Unit, Lapeyronie University Hospital of Montpellier, 191 avenue du Doyen Gaston Giraud, 34295, Montpellier cedex 5, France

    Cyril Lazerges, Benjamin Degeorge, Bertrand Coulet & Michel Chammas

  2. Hip, Knee and Foot Surgery Unit, Lapeyronie University Hospital of Montpellier, 191 avenue du Doyen Gaston Giraud, 34295, Montpellier cedex 5, France

    Louis Dagneaux

  3. Centre ostéo articulaire des Cèdres, 21 Rue Albert Londres, 38432, Échirolles, France

    Nicolas Tardy

Authors
  1. Cyril Lazerges
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  2. Louis Dagneaux
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  3. Benjamin Degeorge
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  4. Nicolas Tardy
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  5. Bertrand Coulet
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  6. Michel Chammas
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Correspondence to Cyril Lazerges.

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

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Lazerges, C., Dagneaux, L., Degeorge, B. et al. Composite reverse shoulder arthroplasty can provide good function and quality of life in cases of malignant tumour of the proximal humerus. International Orthopaedics (SICOT) 41, 2619–2625 (2017). https://doi.org/10.1007/s00264-017-3538-7

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  • DOI: https://doi.org/10.1007/s00264-017-3538-7

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