Related Experiment Video
Updated: Jul 15, 2025
Anterior Capsular Reconstruction with Human Dermal Allograft for Irreparable Subscapularis Tears
Published on: May 9, 2025
Durability of intercalary endoprosthesis for humeral reconstruction
Joshua R Labott1, Mark J Heidenreich1, Samuel E Broida1
1Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA.
Introduction:
The humerus is a common site of metastases and primary tumors. For some patients with a segmental defect and/or diaphyseal cortical destruction a cemented intercalary device may provide a more reliable construct, however data on their use is limited.
Methods:
We reviewed 43 (28 male and 15 female) patients treated with an intercalary humeral spacer at a single tertiary referral center between 1989 and 2022. Humeral lesions were most commonly secondary to metastatic disease (n = 29, 68%), with 25 (58%) patients presenting with a pathologic fracture. Mean age and body mass index were 66 years and 27.9 kg/m2 . First generation taper joint device were used in 22 patients and second-generation lap device in 21 patients.
Results:
Following reconstruction the 2-year overall survival was 30%. Mechanical complications occurred in 11 patients, most commonly aseptic loosening (n = 6, 14%). With death as a competing risk, the cumulative incidence of mechanical failure was 28% at 2-years postoperative. Following the procedure, mean Musculoskeletal Tumor Society scores was 70% and mean shoulder elevation was 87°.
Conclusion:
Reconstruction of the humeral diaphysis with an intercalary endoprosthesis provides restoration of function of the upper extremity, however, is associated with one in four patients having mechanical failure.
