New endoprosthesis suspension method with XXXX monofilament knitted mesh after resection of bone tumors in proximal humerus.

@entity5 @entity1 @entity7502
BACKGROUND: Endoprosthetic reconstruction of the proximal humerus is one of the standard procedures after resection of @entity5 of the proximal humerus and has been considered a reliable method to reconstruct the proximal humerus in recent reports. However, instability of the shoulder joint caused by loss of the rotator cuff and deltoid muscle function is often observed after such an endoprosthetic reconstruction. METHODS: We performed the endoprosthesis suspension method with @entity7502 monofilament knitted mesh. This suspension method, by which the endoprosthesis is suspended from the bone structure, was used after resection of @entity5 in 9 @entity1 . We assessed postoperative stability of the shoulder joint by comparing these @entity1 with 12 @entity1 who underwent the conventional surgical technique, by which the mesh-wrapped endoprosthesis is attached only to soft tissue. RESULTS: In radiographic and physical evaluation, 4 of the 12 @entity1 in the soft tissue reconstruction group showed shoulder joint instability. No @entity1 in the suspension method group showed subluxation of the humeral prosthesis. The mean shoulder flexion was 35   and 65   and the mean shoulder abduction was 40   and 40   for the soft tissue reconstruction group and the suspension method group, respectively. DISCUSSION: Shoulder joint subluxation sometimes occurs because of elongation of the attached soft tissue in the conventional reconstruction with mesh, whereas no shoulder joint subluxation occurs after endoprosthetic reconstruction in the suspension method because the bone structure has no leeway for elongation. Excellent stability of our new method enables exercise of the surgical shoulder at an early stage, leading to improved range of shoulder joint motion.
