Animal model for evaluation of soft tissue ingrowth into various types of porous coating

Endoprosthetic reconstruction of the proximal humerus after tumour resection with polypropylene mesh

PURPOSE

The purpose of this study was to evaluate the functional outcomes and complications of endoprosthesis-PPP mesh composite reconstruction after bone tumour resection of the proximal humerus.

METHODS

We retrospectively analysed 18 patients treated in our department with endoprosthesis-PPP mesh composite reconstruction after bone tumour resection of the proximal humerus between March 2005 and October 2010. Sixteen patients (16/18) were followed up for 56 months (range, 30-96 months). The pre- and post-operative pain severity was assessed according to a 10-cm visual analogue scale (VAS). The clinical results of functional improvement were assessed by Musculoskeletal Tumour Society (MSTS) score at the time of final follow-up. Moreover, we also analysed complications associated with the reconstruction procedure.

RESULTS

Most patients experienced some alleviation of pain two weeks after the reconstruction surgery. The mean MSTS upper extremity functional outcome score at the time of final follow-up was 20 (66.7 %, range, 16-27). Mean shoulder abduction was 36° (range, 18-125°) and mean shoulder flexion was 39° (range, 21-120°). Local recurrence occurred in only one patient (6.25 %), aseptic prosthesis loosening occurred in one patient (6.25 %) and anterior subluxation occurred in one patient (6.25 %).

CONCLUSIONS

The capsule reconstruction on the basis of PPP mesh can significantly reduce the recurrence rate of glenohumeral joint instability, which may offer an alternative for the capsule reconstruction after bone tumour resection of the proximal humerus.

Proximal and total humerus reconstruction with the use of an aortograft mesh

BACKGROUND

The shoulder is commonly affected by primary and metastatic tumors. Current surgical techniques for complex shoulder reconstruction frequently result in functional deficits and instability. A synthetic mesh used in vascular surgery has the biological properties to provide mechanical constraint and improve stability after tumor related shoulder reconstruction.

QUESTIONS/PURPOSES

We describe (1) surgical technique using a synthetic mesh during humerus reconstructions; (2) functional level defined as shoulder ROM of patients undergoing the procedure; (3) incidence of postoperative dislocation and shoulder instability; and (4) complications associated with the use of the device.

METHODS

We retrospectively reviewed 16 patients with proximal humerus replacements reconstructed with a synthetic mesh from February 2006 to July 2008. Patients were followed clinically and radiographically for a minimum of 13 months (mean, 26 months; range, 13-43 months).

RESULTS

There were no shoulder dislocations at the latest followup. The mean shoulder flexion was 43° (range, 15°-170°) and mean shoulder abduction of 38 (range, 15°-110°). The mean operative time was 121 minutes (range, 80-170 minutes) and the mean blood loss was 220 mL (range, 50-750 mL). One patient had a superficial wound infection and none a deep infection requiring removal of the graft or prosthesis.

CONCLUSIONS

The data suggest the use of a synthetic vascular mesh for proximal humerus reconstruction may reduce dislocations and facilitate soft tissue attachment and reconstruction after tumor resection.