Abstract
Purpose
Recently, endoprosthesis reconstruction has been used for scapular malignant tumours. Our aim is to present and evaluate the clinical indications, peri-operative technique, and mid-term clinical results.
Methods
Scapular hemiarthroplasty after total scapulectomy has been performed in 15 patients between 2011 and 2014. Clinical records and radiographs were evaluated retrospectively.
Results
The average follow-up was 41.2 months. No infection, dislocation, pressure ulcer, wound healing problems or mechanical failures were reported. Three patients died due to lung metastasis. The final follow-up average Musculoskeletal Tumor Society (MSTS) scoring system score was 25.3 points. The average ranges of motion of shoulder abduction and forward flexion were 45.3°and 65.7°, respectively. There were significant differences in function, lifting ability, MSTS scores, abduction function and flexion function between the seven patients with artificial ligament reconstruction for articular capsule and the others with direct suture. Three patients who had reconstruction of the rotator cuff were verified to gain better post-operative hand positioning, lifting ability, MSTS score, and abduction function than the others without rotator cuff reconstruction.
Conclusions
As long as the indications and surgical skills are fully mastered, reconstruction with the scapular hemiarthroplasty endoprosthesis can result in mid-term oncologic salvage, good post-operative function and low complication rate after scapulectomy for malignant tumors.
Similar content being viewed by others
References
Mayil Vahanan N, Mohanlal P, Bose JC, Gangadharan R, Karthisundar V (2007) The functional and oncological results after scapulectomy for scapular tumours: 2-16-year results. Int Orthop 31(6):831–836. doi:10.1007/s00264-006-0261-1
Gibbons CL, Bell RS, Wunder JS, Griffin AM, O'Sullivan B, Catton CN, Davis AM (1998) Function after subtotal scapulectomy for neoplasm of bone and soft tissue. The Journal of bone and joint surgery British volume 80(1):38–42
O'Connor MI, Sim FH, Chao EY (1996) Limb salvage for neoplasms of the shoulder girdle. Intermediate reconstructive and functional results. J Bone Joint Surg Am 78 (12):1872–1888
Puchner SE, Panotopoulos J, Puchner R, Schuh R, Windhager R, Funovics PT (2014) Primary malignant tumours of the scapula—a review of 29 cases. Int Orthop 38(10):2155–2162. doi:10.1007/s00264-014-2417-8
Mavrogenis AF, Mastorakos DP, Triantafyllopoulos G, Sakellariou VI, Galanis EC, Papagelopoulos PJ (2009) Total scapulectomy and constrained reverse total shoulder reconstruction for a Ewing’s sarcoma. J Surg Oncol 100(7):611–615. doi:10.1002/jso.21340
Xu SF, Yu XC, Xu M, Hu YC, Liu XP (2016) Functional results and emotional acceptance after scapulectomy for malignant shoulder tumors. Orthop Surg 8(2):186–195. doi:10.1111/os.12248
Mnaymneh WA, Temple HT, Malinin TI (2002) Allograft reconstruction after resection of malignant tumors of the scapula. Clin Orthop Relat Res 405:223–229
Zhang K, Duan H, Xiang Z, Tu C (2009) Surgical technique and clinical results for scapular allograft reconstruction following resection of scapular tumors. J Exp Clin Cancer Res 28:45. doi:10.1186/1756-9966-28-45
Scalise JJ, Iannotti JP (2008) Bone grafting severe glenoid defects in revision shoulder arthroplasty. Clinical orthopaedics and related research 466(1):139–145. doi:10.1007/s11999-007-0065-7
Yang Q, Li J, Yang Z, Li X, Li Z (2010) Limb sparing surgery for bone tumours of the shoulder girdle: the oncological and functional results. Int Orthop 34(6):869–875. doi:10.1007/s00264-009-0857-3
Capanna R, Totti F, Van der Geest IC, Muller DA (2015) Scapular allograft reconstruction after total scapulectomy: surgical technique and functional results. J Shoulder Elb Surg 24(8):e203–e211. doi:10.1016/j.jse.2015.02.006
Schwab JH, Athanasian EA, Morris CD, Boland PJ, Healey JH (2006) Function correlates with deltoid preservation in patients having scapular replacement. Clinical orthopaedics and related research 452:225–230. doi:10.1097/01.blo.0000229323.37793.6d
Pritsch T, Bickels J, Wu CC, Squires MH, Malawer MM (2007) Is scapular endoprosthesis functionally superior to humeral suspension? Clinical orthopaedics and related research 456:188-195. doi:10.1097/01.blo.0000238840.26423.b6
Wittig JC, Bickels J, Wodajo F, Kellar-Graney KL, Malawer MM (2002) Constrained total scapula reconstruction after resection of a high-grade sarcoma. Clin Orthop Relat Res 397:143–155
Masamed R, Learch TJ, Menendez LR (2008) En bloc shoulder resection with total shoulder prosthetic replacement: indications and imaging findings. AJR Am J Roentgenol 191 (2):482–489. doi:10.2214/ajr.07.3286
Enneking WF, Spanier SS, Goodman MA (1980) A system for the surgical staging of musculoskeletal sarcoma. Clin Orthop Relat Res (153):106–120
Malawer MM, Meller I, Dunham WK (1991) A new surgical classification system for shoulder-girdle resections. Analysis of 38 patients. Clin Orthop Relat Res 267:33–44
Enneking WF, Dunham W, Gebhardt MC, Malawar M, Pritchard DJ (1993) A system for the functional evaluation of reconstructive procedures after surgical treatment of tumors of the musculoskeletal system. Clin Orthop Relat Res 286:241–246
Hayashi K, Karita M, Yamamoto N, Shirai T, Nishida H, Takeuchi A, Kimura H, Miwa S, Tsuchiya H (2011) Functional outcomes after total scapulectomy for malignant bone or soft tissue tumors in the shoulder girdle. Int J Clin Oncol 16(5):568–573
Tang X, Guo W, Yang R, Ji T, Sun X (2011) Reconstruction with constrained prosthesis after total scapulectomy. Journal of shoulder and elbow surgery/American Shoulder and Elbow Surgeons [et al] 20(7):1163–1169. doi:10.1016/j.jse.2010.12.014
Schneiderbauer MM, Blanchard C, Gullerud R, Harmsen WS, Rock MG, Shives TC, Sim FH, Scully SP (2004) Scapular chondrosarcomas have high rates of local recurrence and metastasis. Clinical orthopaedics and related research (426):232-238
Bickels J, Wittig JC, Kollender Y, Kellar-Graney K, Meller I, Malawer MM (2002) Limb-sparing resections of the shoulder girdle. J Am Coll Surg 194(4):422–435
Lavoie P, Fletcher J, Duval N (2000) Patient satisfaction needs as related to knee stability and objective findings after ACL reconstruction using the LARS artificial ligament. Knee 7(3):157–163
Reed D, Cathers I, Halaki M, Ginn KA (2016) Does load influence shoulder muscle recruitment patterns during scapular plane abduction? J Sci Med Sport 19(9):755–760. doi:10.1016/j.jsams.2015.10.007
Acknowledgements
Dr. Min is supported through the new teacher fund of the Ministry of Education in China (20120181120028) and the science and technology support program of Sichuan Province (2012SZ0014). The authors thank Cassandra Garbutt for assistance with editing the manuscript.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest statement
None of the authors have any financial and personal relationships with individuals or organizations that could inappropriately influence this work.
Ethical approval
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Rights and permissions
About this article
Cite this article
Min, L., Zhou, Y., Tang, F. et al. Reconstruction with scapular hemiarthroplasty endoprosthesis after scapulectomy for malignant tumour. International Orthopaedics (SICOT) 41, 1057–1063 (2017). https://doi.org/10.1007/s00264-017-3429-y
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00264-017-3429-y