Custom-made prosthesis replacement for reconstruction of elbow after tumor resection

J Shoulder Elbow Surg. 2009 Sep-Oct;18(5):796-803. doi: 10.1016/j.jse.2009.01.022. Epub 2009 Jul 1.

Abstract

Hypothesis: The options for reconstruction after excision of a tumor around the elbow are technically difficult and limited.

Materials and methods: We retrospectively reviewed 25 patients who underwent custom-made endoprosthetic reconstruction after tumor resection near the elbow between 1998 and 2007.

Results: At final follow-up, 14 patients (56%) were alive, and 11 (44%) had died of their disease. Local recurrence was encountered in 4 patients (16%). Complications occurred in 6 patients (24%), including vascular injury, neurapraxia of the radial nerve, and aseptic loosening in 4. The average Musculoskeletal Tumor Society 93 score was 23.9 points, and the average Mayo Elbow Performance score was 82 points. Pain was relieved in all patients, although some limitations of lifting ability were reported. Ten patients had an arc of elbow motion of more than 100 degrees after reconstruction.

Conclusions: In most patients, local tumor resection and prosthetic reconstruction of the elbow can be done with oncologic safety, and provides good function with low rates of complications.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Arthroplasty, Replacement*
  • Bone Neoplasms / pathology
  • Bone Neoplasms / rehabilitation
  • Bone Neoplasms / surgery*
  • Cohort Studies
  • Elbow Joint / pathology
  • Elbow Joint / surgery*
  • Female
  • Follow-Up Studies
  • Humans
  • Humerus / pathology
  • Humerus / surgery*
  • Joint Prosthesis*
  • Limb Salvage / methods
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Pain Measurement
  • Plastic Surgery Procedures / methods
  • Postoperative Care
  • Preoperative Care / methods
  • Prosthesis Design
  • Prosthesis Failure
  • Prosthesis Fitting
  • Range of Motion, Articular / physiology
  • Retrospective Studies
  • Risk Assessment
  • Survival Analysis
  • Time Factors
  • Treatment Outcome
  • Young Adult