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Related Experiment Videos

Prosthetic replacement of the proximal humerus.

G Bos1, F Sim, D Pritchard

  • 1Mayo Clinic/Mayo Foundation Department of Orthopedic Surgery, Rochester, MN 55905.

Clinical Orthopaedics and Related Research
|November 1, 1987
PubMed
Summary

Proximal humeral replacement using metal or ceramic prostheses showed good arm function but high failure rates, particularly with ceramic designs. This initial study highlights the need for further investigation into shoulder arthroplasty to improve outcomes.

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Area of Science:

  • Orthopedic Surgery
  • Biomaterials Science
  • Reconstructive Surgery

Background:

  • Prosthetic proximal humeral replacement is a complex procedure indicated for various conditions including nonunions, neoplasms, and malignancies.
  • Evaluating the performance and longevity of different prosthetic materials is crucial for optimizing patient outcomes.

Purpose of the Study:

  • To assess the outcomes of prosthetic proximal humeral replacement using both metal and ceramic prostheses.
  • To identify failure modes and complications associated with these implants.

Main Methods:

  • A retrospective review of 18 patients who underwent prosthetic proximal humeral replacement.
  • Analysis of implant survival, complication rates, and functional outcomes, categorized by prosthesis type (metal vs. ceramic) and indication.

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Main Results:

  • Good retention of elbow and hand function was observed across all patients.
  • Ceramic prostheses experienced a high failure rate (5 of 11) at the humeral-prosthetic junction.
  • A significant number of prostheses subluxated or dislocated (10 of 18), leading to a high revision rate (12 of 18).

Conclusions:

  • While prosthetic proximal humeral replacement can preserve limb function, current designs, especially ceramic ones, exhibit substantial failure rates.
  • The high incidence of subluxation, dislocation, and revision surgeries indicates a need for improved implant design and surgical techniques.
  • This initial series provides valuable insights for future research and development in shoulder arthroplasty.