Reconstruction with a double-constrained implant design after complex shoulder extra-articular resection
The result's identifiers
Result code in IS VaVaI
<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00064211%3A_____%2F23%3AW0000010" target="_blank" >RIV/00064211:_____/23:W0000010 - isvavai.cz</a>
Alternative codes found
RIV/68407700:21220/23:00370609 RIV/00216208:11110/23:10469486
Result on the web
<a href="https://oadoi.org/10.1186/s12957-023-03173-9" target="_blank" >https://oadoi.org/10.1186/s12957-023-03173-9</a>
DOI - Digital Object Identifier
<a href="http://dx.doi.org/10.1186/s12957-023-03173-9" target="_blank" >10.1186/s12957-023-03173-9</a>
Alternative languages
Result language
angličtina
Original language name
Reconstruction with a double-constrained implant design after complex shoulder extra-articular resection
Original language description
BackgroundApproximately, one-third of patients with tumors of proximal humerus will require an extra-articular resection to achieve oncologic margins. This procedure yields poor functional outcomes with a considerable rate of revisions. Unconstrained implants are prone to instability hindering also function of the elbow and hand, whereas constrained shoulder reconstructions suffer from early aseptic loosening of the glenoid component due to bone overload. The purpose of this study was to develop a constrained implant suitable for extra-articular resection with loss of function in deltoid and rotator cuff, which would provide both stability and passive motion, whilst also decreasing the risk of aseptic loosening of the glenoid component.MethodsIn cooperation with Czech Technical University in Prague, we devised an implant consisting of two constrained joints in series connected by a dumbbell piece. The biomechanical analysis showed a reduction of load transfer to the glenoid component with a torque of 8.6 Nm capable of generating an 865-N pulling force on bone screw to just 0.07 Nm, hence shielding the glenoid component from undesired forces and decreasing the risk of aseptic loosening. Three patients with extra-articular resection with a total loss of function of both rotator cuff and deltoid muscle received this type of reconstruction. The average follow-up was 16 months.ResultsThe surgical technique is straightforward. The surgery took 175 min on average with average blood loss of 516 ml. There were no surgical- or implant-related complications. All three patients were pain-free and had a stable shoulder joint after the reconstruction. All had fully functional elbow, wrist, and hand joints. The average Musculoskeletal Tumor Society (MSTS) score was 21/30 (70%). All patients were pleased with the results.ConclusionThe presented innovative implant design has demonstrated to be a promising alternative for reconstruction in these challenging cases.
Czech name
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Czech description
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Classification
Type
J<sub>imp</sub> - Article in a specialist periodical, which is included in the Web of Science database
CEP classification
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OECD FORD branch
30204 - Oncology
Result continuities
Project
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Continuities
I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace
Others
Publication year
2023
Confidentiality
S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů
Data specific for result type
Name of the periodical
WORLD JOURNAL OF SURGICAL ONCOLOGY
ISSN
1477-7819
e-ISSN
1477-7819
Volume of the periodical
21
Issue of the periodical within the volume
1
Country of publishing house
GB - UNITED KINGDOM
Number of pages
9
Pages from-to
-
UT code for WoS article
001069326100002
EID of the result in the Scopus database
2-s2.0-85171374852