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Resection and reconstruction with and without neoadjuvant denosumab in campanacci grade III giant cell tumors of proximal humerus: a retrospective comparative study

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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Background

Giant cell tumors (GCT) of the proximal humerus are rarely reported case that requires complex surgeries due to involvement of the shoulder joint. Therefore, we report the first retrospective comparative study where the postoperative functional outcomes, recurrence rate and complications in patients who underwent arthrodesis of shoulder after resection of grade III GCT with and without neoadjuvant denosumab are compared.

Methods

A retrospective review of eight cases of grade III GCT of proximal humerus receiving resection and fibular strut graft and arthrodesis between January 2014 and December 2019 is performed. They were stratified into two groups: one group of four patients received once-weekly denosumab 120 mg for 4-weeks before resection and reconstruction, while the other group of four patients did not receive denosumab before surgery. Primary outcomes included the functional outcomes assessed by revised Musculoskeletal tumor society (MSTS) score and shoulder pain and disability index (SPDI) at 6-weeks and 12-months postoperatively while secondary outcomes included complications and recurrences.

Results

There was no significant difference in terms of SPDI at 6 weeks and 12 months, MSTS at 12 months, complications, recurrence among denosumab and non-denosumab groups. At 6-weeks follow-up, a significantly better pain score in SPDI and MSTS was acquired in the denosumab group.

Conclusions

Resection and reconstruction with or without neoadjuvant denosumab for Grade III GCT of proximal humerus had similar functional outcomes and with no major differences in recurrence and complications. Hence, postoperative pain relief while long-term benefits were not discovered with the use of neoadjuvant denosumab.

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Availability of data and materials

All data were obtained from Orthopedic Surgery Department of Dr Ruth KM Pfau Civil Hospital Karachi, Pakistan.

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Authors and Affiliations

  1. Dow University of Health Sciences/Dr Ruth KM Pfau Civil Hospital Karachi, Baba e Urdu Road, Saddar, Karachi, Pakistan

    Badaruddin Sahito, Awais Abro, Javed Ahmed &  Younis

  2. Dr Ruth KM Pfau Civil Hospital Karachi, Baba e Urdu Road, Saddar, Karachi, Pakistan

    Sheikh Muhammad Ebad Ali & Sofia Fatima Farooqui

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  1. Badaruddin Sahito
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  2. Sheikh Muhammad Ebad Ali
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  4. Awais Abro
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  5. Javed Ahmed
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Contributions

All authors contributed to the conception and design of this evaluation, as well as to the analysis and interpretation of data. MT wrote, and all authors contributed to and reviewed the manuscript.

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Correspondence to Sheikh Muhammad Ebad Ali.

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Sahito, B., Ali, S.M.E., Farooqui, S.F. et al. Resection and reconstruction with and without neoadjuvant denosumab in campanacci grade III giant cell tumors of proximal humerus: a retrospective comparative study. Eur J Orthop Surg Traumatol 33, 81–88 (2023). https://doi.org/10.1007/s00590-021-03162-2

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  • DOI: https://doi.org/10.1007/s00590-021-03162-2

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