Modular Prostheses Provide Stable Elbow Reconstruction

Post-tumor resection modular prosthesis offers stable and functional elbow with disease control

MONDAY, June 13 (HealthDay News) -- Elbow reconstruction with modular prostheses of the distal end of the humerus offers stable reconstruction after tumor resection, but it is less successful for revision surgery in patients without a tumor, according to a study published in the June 1 issue of The Journal of Bone & Joint Surgery.

Philipp T. Funovics, M.D., from the Vienna General Hospital in Austria, and colleagues investigated the outcomes of distal humeral reconstruction with a modular prosthesis in 53 elbows from 52 patients with either an elbow tumor (38 elbows) or massive joint degeneration (15 elbows). Metastatic disease was seen in 23 patients (24 elbows), and 14 had a primary tumor. Reconstruction included 12 total humeral replacements and 41 distal humeral replacements. The patients were followed up for an average of 28 months.

The investigators found that, compared to patients with distal humeral reconstruction, those with total humeral reconstruction had worse Inglis-Pellicci scores. In the tumor group, local control was achieved in all patients, and the average Musculoskeletal Tumor Society score was 78 percent. The tumor group had a significantly better average Inglis-Pellicci score than the revision group (84 and 76 points, respectively). Major complications included eight patients with deep periprosthetic infection, necessitating amputation in one patient and prosthetic removal in two patients, and four patients with aseptic loosening who needed implant revision.

"Modular prostheses of the distal end of the humerus provide a stable reconstruction of the elbow with satisfactory function and disease control in patients with a tumor, but careful patient selection is required when the prostheses are used for revision surgery in patients without a tumor," the authors write.

One or more of the study authors disclosed financial relationships with the biomedical industry.

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