Allograft Prosthetic Composite (APC) for Proximal Humeral Bone Deficiency in Revision Reverse Shoulder Arthroplasty:...

Area of Science:

• Orthopedic Surgery
• Biomaterials Science
• Radiology

Background:

• Proximal humeral bone deficiency presents a significant challenge in revision shoulder arthroplasty, particularly with the increasing use of reverse shoulder arthroplasty (RSA).
• Addressing bone loss in the proximal humerus is critical for successful revision shoulder procedures.

Purpose of the Study:

• To present a technical note on preoperative planning, surgical techniques, and rationale for using allograft prosthetic composite (APC) in revision RSA for proximal humeral bone deficiency.
• To report the outcomes of this technique and present a systematic review of existing literature on RSA with APCs.

Main Methods:

• Detailed description of preoperative planning and surgical technique for proximal humeral reconstruction using APC during revision arthroplasty.
• Presentation of preliminary clinical and radiological results from five patients undergoing revision shoulder arthroplasty with APC reconstruction.
• Systematic review following PRISMA guidelines, searching PubMed, Embase, and Cochrane databases for studies on RSA with APCs.

Main Results:

• Systematic review included 14 studies with 255 patients (mean follow-up 57 months).
• Both the systematic review and the author's case series showed improvements in pain, range of motion, function, and patient satisfaction.
• Graft incorporation rate was 84% in the systematic review.

Conclusions:

• The use of an allograft prosthetic composite (APC) construct is a viable option for addressing proximal humeral bone deficiency in revision shoulder arthroplasty.
• This technique offers a promising solution for complex cases requiring humeral reconstruction in revision RSA.