Reconstruction with scapular hemiarthroplasty endoprosthesis after scapulectomy for malignant tumour

Abstract

Recently, endoprosthesis reconstruction has been used for scapular malignant tumours. Our aim is to present and evaluate the clinical indications, peri-operative technique, and mid-term clinical results. Scapular hemiarthroplasty after total scapulectomy has been performed in 15 patients between 2011 and 2014. Clinical records and radiographs were evaluated retrospectively. The average follow-up was 41.2months. No infection, dislocation, pressure ulcer, wound healing problems or mechanical failures were reported. Three patients died due to lung metastasis. The final follow-up average Musculoskeletal Tumor Society (MSTS) scoring system score was 25.3 points. The average ranges of motion of shoulder abduction and forward flexion were 45.3°and 65.7°, respectively. There were significant differences in function, lifting ability, MSTS scores, abduction function and flexion function between the seven patients with artificial ligament reconstruction for articular capsule and the others with direct suture. Three patients who had reconstruction of the rotator cuff were verified to gain better post-operative hand positioning, lifting ability, MSTS score, and abduction function than the others without rotator cuff reconstruction. As long as the indications and surgical skills are fully mastered, reconstruction with the scapular hemiarthroplasty endoprosthesis can result in mid-term oncologic salvage, good post-operative function and low complication rate after scapulectomy for malignant tumors.