Skip to main content

Proximal Humerus Neoplasia

  • Chapter
  • First Online:
Reverse Shoulder Arthroplasty
  • 929 Accesses

Abstract

The reconstruction of the proximal humerus following a tumor resection remains a big challenge for the orthopedic surgeon, due to the complex anatomy and biomechanics of the shoulder joint. The main goals, after a resection with adequate margins, are the stability of the glenohumeral joint and the restoration of passive and active mobility. The proximal humerus reconstruction can be performed with an allograft and/or an endoprosthetic replacement. The resected tendons should be resutured to the prosthesis or the allograft to improve the functional results. The shoulder joint reconstruction with a reverse shoulder prosthesis seems to allow the best functional results, in particular if the circumflex nerve and the deltoid muscle are spared.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 119.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 159.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Malawer MM. Overview of resections around the shoulder girdle: anatomy, surgical consideration and classifications. In: Musculoskeletal cancer surgery; 2001.

    Google Scholar 

  2. Enneking W, Dunham W, Gebhardt M, Malawar M, Pritchard D. A system for the classification of skeletal resections. Chir Organi Mov. 1990;75(1 Suppl):217–40.

    CAS  PubMed  Google Scholar 

  3. Jemal A, Siegel R, Ward E, Murray T, Xu J, Thun MJ. Cancer statistics, 2007. CA Cancer J Clin. 2007;57(1):43–66.

    Article  Google Scholar 

  4. Aaron AD. Treatment of metastatic adenocarcinoma of the pelvis and the extremities. J Bone Joint Surg Am. 1997;79(6):917–32.

    Article  CAS  Google Scholar 

  5. Fottner A, Szalantzy M, Wirthmann L, Stähler M, Baur-Melnyk A, Jansson V, et al. Bone metastases from renal cell carcinoma: patient survival after surgical treatment. BMC Musculoskelet Disord. 2010;11:145.

    Article  Google Scholar 

  6. De Wilde L, Boileau P, Van der Bracht H. Does reverse shoulder arthroplasty for tumors of the proximal humerus reduce impairment? Clin Orthop. 2011;469(9):2489–95.

    Article  Google Scholar 

  7. Teunis T, Nota SPFT, Hornicek FJ, Schwab JH, Lozano-Calderón SA. Outcome after reconstruction of the proximal humerus for tumor resection: a systematic review. Clin Orthop. 2014;472(7):2245–53.

    Article  Google Scholar 

  8. Malawer MM. Tumors of the shoulder girdle. Technique of resection and description of a surgical classification. Orthop Clin North Am. 1991;22(1):7–35.

    CAS  PubMed  Google Scholar 

  9. Bus MPA, van de Sande MA, Taminiau AHM, Dijkstra PDS. Is there still a role for osteoarticular allograft reconstruction in musculoskeletal tumour surgery? A long-term follow-up study of 38 patients and systematic review of the literature. Bone Joint J. 2017;99–B(4):522–30.

    Google Scholar 

  10. Streitbuerger A, Henrichs M, Gosheger G, Ahrens H, Nottrott M, Guder W, et al. Improvement of the shoulder function after large segment resection of the proximal humerus with the use of an inverse tumour prosthesis. Int Orthop. 2015;39(2):355–61.

    Article  Google Scholar 

  11. Cannon CP, Paraliticci GU, Lin PP, Lewis VO, Yasko AW. Functional outcome following endoprosthetic reconstruction of the proximal humerus. J Shoulder Elb Surg. 2009;18(5):705–10.

    Article  Google Scholar 

  12. Abdeen A, Healey JH. Allograft-prosthesis composite reconstruction of the proximal part of the humerus: surgical technique. J Bone Joint Surg Am. 2010;92(Suppl 1 Pt 2):188–96.

    Article  Google Scholar 

  13. King JJ, Nystrom LM, Reimer NB, Gibbs CP, Scarborough MT, Wright TW. Allograft-prosthetic composite reverse total shoulder arthroplasty for reconstruction of proximal humerus tumor resections. J Shoulder Elb Surg. 2016;25(1):45–54.

    Article  Google Scholar 

  14. Sheth M, Ko J-WK, Namdari S. Reverse shoulder arthroplasty and latissimus dorsi tendon transfer. Am J Orthop (Belle Mead NJ). 2017;46(5):E287–92.

    Google Scholar 

  15. Wey A, Dunn JC, Kusnezov N, Waterman BR, Kilcoyne KG. Improved external rotation with concomitant reverse total shoulder arthroplasty and latissimus dorsi tendon transfer: a systematic review. J Orthop Surg (Hong Kong). 2017;25(2):2309499017718398.

    Article  Google Scholar 

  16. van de Sande MAJ, Dijkstra PDS, Taminiau AHM. Proximal humerus reconstruction after tumour resection: biological versus endoprosthetic reconstruction. Int Orthop. 2011;35(9):1375–80.

    Google Scholar 

  17. De Wilde LF, Plasschaert FS, Audenaert EA, Verdonk RC. Functional recovery after a reverse prosthesis for reconstruction of the proximal humerus in tumor surgery. Clin Orthop. 2005;430:156–62.

    Article  Google Scholar 

  18. Guven MF, Aslan L, Botanlioglu H, Kaynak G, Kesmezacar H, Babacan M. Functional outcome of reverse shoulder tumor prosthesis in the treatment of proximal humerus tumors. J Shoulder Elb Surg. 2016;25(1):e1–6.

    Article  Google Scholar 

  19. Bonnevialle N, Mansat P, Lebon J, Laffosse J-M, Bonnevialle P. Reverse shoulder arthroplasty for malignant tumors of proximal humerus. J Shoulder Elb Surg. 2015;24(1):36–44.

    Article  Google Scholar 

  20. Potter BK, Adams SC, Pitcher JD, Malinin TI, Temple HT. Proximal humerus reconstructions for tumors. Clin Orthop. 2009;467(4):1035–41.

    Article  Google Scholar 

  21. Kassab M, Dumaine V, Babinet A, Ouaknine M, Tomeno B, Anract P. Twenty nine shoulder reconstructions after resection of the proximal humerus for neoplasm with mean 7-year follow-up. Rev Chir Orthop Reparatrice Appar Mot. 2005;91(1):15–23.

    Article  CAS  Google Scholar 

  22. Kaa AKS, Jørgensen PH, Søjbjerg JO, Johannsen HV. Reverse shoulder replacement after resection of the proximal humerus for bone tumours. Bone Joint J. 2013;95–B(11):1551–5.

    Article  Google Scholar 

  23. Zumstein MA, Pinedo M, Old J, Boileau P. Problems, complications, reoperations, and revisions in reverse total shoulder arthroplasty: a systematic review. J Shoulder Elb Surg. 2011;20(1):146–57.

    Article  Google Scholar 

  24. Lädermann A, Walch G, Lubbeke A, Drake GN, Melis B, Bacle G, et al. Influence of arm lengthening in reverse shoulder arthroplasty. J Shoulder Elb Surg. 2012;21(3):336–41.

    Article  Google Scholar 

  25. Raiss P, Kinkel S, Sauter U, Bruckner T, Lehner B. Replacement of the proximal humerus with MUTARS tumor endoprostheses. Eur J Surg Oncol. 2010;36(4):371–7.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Raimondo Piana .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Piana, R., Ratto, N., Ferro, A., Boffano, M. (2019). Proximal Humerus Neoplasia. In: Gumina, S., Grassi, F., Paladini, P. (eds) Reverse Shoulder Arthroplasty. Springer, Cham. https://doi.org/10.1007/978-3-319-97743-0_24

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-97743-0_24

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-97742-3

  • Online ISBN: 978-3-319-97743-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics