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Reverse Total Shoulder Arthroplasty
Published on: July 5, 2011
Total scapulectomy and constrained reverse total shoulder reconstruction for a Ewing's sarcoma
Andreas F Mavrogenis1, Dimitrios P Mastorakos, Georgios Triantafyllopoulos
1First Department of Orthopaedics, ATTIKON University Hospital, Athens Medical School, Athens Greece.
Journal of Surgical Oncology
|July 8, 2009
Summary
This study presents a novel shoulder reconstruction technique for scapular Ewing's sarcoma, achieving a stable and painless shoulder with clear surgical margins. Prosthetic replacement partially restores arm function and improves appearance.
Area of Science:
- Orthopedic oncology
- Surgical reconstruction
- Musculoskeletal oncology
Background:
- Malawer Type III shoulder girdle resection involves total scapulectomy and intra-articular glenohumeral joint resection.
- Ewing's sarcoma of the scapula presents a significant challenge for limb salvage surgery.
- Shoulder reconstruction aims to restore function and cosmesis after extensive oncologic resection.
Observation:
- A modified Tikhoff-Linberg total scapulectomy and constrained reverse total shoulder reconstruction was performed for scapular Ewing's sarcoma.
- The procedure involved en bloc tumor removal with preservation of surrounding muscles.
- A scapular prosthesis was suspended, and a constrained reverse humeral prosthesis was implanted.
Findings:
- No intraoperative or postoperative complications were observed.
- Surgical margins were clear, indicating successful tumor removal.
- At 12 months postoperatively, the patient achieved a stable and painless shoulder.
Implications:
- Prosthetic replacement of the scapula and shoulder offers a viable solution for limb salvage in scapular tumors.
- This reconstruction technique partially restores shoulder abduction and external rotation.
- Improved cosmesis and function are observed compared to patients without scapula reconstruction.
