Original articleTreatment of proximal humeral chondrosarcoma with resection and allograft
Section snippets
Materials and methods
In an article published in 1990, we reported on 20 patients with tumors of the humerus treated by resection and allograft replacement, 9 of whom had had chondrosarcomas.11 In the present series of patients treated since 1972 and listed in our database, we found 499 patients who had had a chondrosarcoma.19 In only 64 of these patients were tumors located in the proximal humerus. Proximal humeral resection and implant of a cadaveric allograft was done in 31 patients, 26 were treated with massive
Results
As can be noted by study of Table II, there were no significant differences for the complications for patients with allografts and those with metallic devices. The metallic devices had a shorter duration of follow-up because modular and special devices were not available in the early years of our treatment.
Table III shows that the success of the allograft transplantation over the mean period of 15 years was 77%, which was similar to that in the femur and tibia and better (P < .03) than for the
Discussion
Chondrosarcoma of the proximal humerus is uncommon. Only 64 of 499 of our patients with chondrosarcomas had tumors at that site. Thirty-one of the chondrosarcomas were resected and replaced with a cadaveric allograft and 26 with metallic implants. The results for the 2 series of implants were virtually identical, although the follow-up period was shorter for the metal components. The survival data for the entire series of 57 patients were remarkably good, with only 3 deaths. The survival rate
Conclusion
Although resection and allograft replacement is by no means a perfect solution for patients with proximal humeral chondrosarcoma, the end results for patient survival, allograft retention, and maintenance of structure are reasonably good, and the system remains as a useful approach.
References (36)
- et al.
Twenty-nine shoulder reconstructions after resection of the proximal humerus for neoplasm with mean 7 year follow-up
Rev Chir Orhop Reparatrice Appar Mot
(2005) - et al.
Low risk of recurrence of enchondroma and low grade chondrosarcoma in extremities80 patients followed for 2-25 years
Acta Orthop Scand
(1995) - et al.
Fractures of allograftsFrequency, treatment and end results
J Bone Joint Surg Am
(1990) - et al.
Prosthetic replacement of the proximal humerus
Clin Orthop
(1987) - et al.
Excision of tumours of humerus and femur with restoration by internal prostheses
J Bone Joint Surg Br
(1975) Bone and soft tissue tumors
- et al.
The use of a modular titanium endoprosthesis in skeletal reconstructions after bone tumor resections: method presentation and analysis of 37 cases
Rev Hosp Clin Fac Med Sao Paulo
(2000) - et al.
Functional recovery after a reverse prosthesis for reconstruction of the proximal humerus in tumor surgery
Clin Orthop
(2005) - et al.
Bone tumors
A system of staging musculoskeletal neoplasms
Clin Orthop
(1986)