[Reconstruction of proximal humerus tumors with massive osteoarticular allograft transplantation]

To analyze the functional efficacies and complications for the reconstruction of defects in proximal humerus tumors with massive osteoarticular allograft transplantation and evaluate the feasibility of this method.

A retrospective review was performed for proximal humerus tumors surgically treated and followed up from November 2001 to November 2008. There were 6 males and 1 female with an average age of 38.4 years old (range: 21 - 65). The tumor characteristics were as follows: giant cell tumor (n = 5), osteosarcoma (n = 1) and malignant fibrous tissue tumor (n = 1). According to the Enneking classification system, there were IA (n = 5), IIA (n = 1) and IIB (n = 1). All patients were reconstructed with massive osteoarticular allograft transplantation and immobilized with interlocking nail. The average length of massive allograft was 15.2 cm (range: 11 - 19).

All patients were followed up for an average of 5.5 years (range: 2 - 8). In a long-term follow-up, atrophy and adsorption of allograft were found in all cases without clinical symptoms. This phenomenon started to appear after 1.5 years. And bone graft disappeared completely in around 6 years postoperatively. The atrophy of bone graft usually originated from greater tubercles and extended gradually to metaphysic. According to the Musculoskeletal Tumor Society (MSTS) functional classification system, the average score of osteoarticular allografts was 17.6 (range: 15 - 19). According to the MSTS radiological evaluation system, the long-term perfect/fair rate was 0.

Massive osteoarticular allograft transplantation is one of feasible options for the reconstruction of structural bone defects due to bone tumor resection.