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Does the second-generation intercalary humeral spacer improve on the first?
Timothy A Damron1, Taninnit Leerapun, Ronald R Hugate
1Department of Orthopedics, State University of New York Upstate Medical University, Suite 130, 550 Harrison Street, Syracuse, NY 13202, USA. damront@upstate.edu
Clinical Orthopaedics and Related Research
|April 19, 2008
Summary
The second-generation lap joint humeral spacer shows fewer complications than the first-generation male-female taper design. While aseptic loosening was more common with the lap joint, it avoided issues like neuropraxia and fracture seen in the earlier design.
Area of Science:
- Orthopedic surgery
- Oncology
- Biomedical engineering
Background:
- First-generation intercalary humeral spacers had design weaknesses.
- A second-generation lap joint design was developed to address these issues.
Purpose of the Study:
- To evaluate if the second-generation lap joint intercalary humeral spacer reduces complications compared to the original male-female taper design.
Main Methods:
- Retrospective review of 32 patients who received intercalary humeral spacers.
- Comparison between 21 patients with male-female taper design and 11 with lap joint design.
- Analysis of demographic, tumor, treatment, and radiographic variables.
Main Results:
- Lower overall complication rate in the lap joint group (3/11) versus the male-female taper group (11/21).
- Complications like neuropraxia, periprosthetic fracture, and disengagement were absent in the lap joint group.
- Aseptic loosening was more frequent in the lap joint group; no differences in blood loss, operative time, or Musculoskeletal Tumor Society scores.
Conclusions:
- The lap joint humeral spacer design is associated with a reduced complication profile compared to the male-female taper design.
- Improvement in Musculoskeletal Tumor Society scores was observed in both groups postoperatively.
- Use of these implants is recommended for patients with limited life expectancy.
