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Updated: Jan 11, 2026
Reverse Total Shoulder Arthroplasty
Published on: July 5, 2011
Functional Outcomes of Reverse Shoulder Arthroplasty and Allograft-Prosthetic Composite in Oncologic Patients
Lotte R van der Linden1, Marcos R Gonzalez, Jordan O Gasho
1From the Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, MA (van der Linden, Gonzalez, Gasho, Ubong, Elhassan, and Lozano-Calderon), the Department of Orthopaedic Surgery, University Medical Center Groningen, Groningen, the Netherlands (van der Linden), the Department of Orthopaedic Surgery, Keck School of Medicine of USC, Los Angeles, CA (Kang).
Introduction:
Reverse total shoulder arthroplasty (rTSA) is a feasible reconstruction technique for proximal humerus tumors and can be combined with allograft-prosthetic composite (rTSA-APC) for extensive lesions. We assessed postoperative complications and functional outcomes after rTSA with and without allograft prosthetic composites for oncologic indications, comparing them with a matched nononcologic cohort.
Methods:
Twenty-three patients who underwent rTSA with or without allograft prosthetic composites after proximal humerus tumor resection between 2010 and 2022 were included. We defined two groups in the oncologic cohort: rTSA (15 patients) and rTSA-APC (8 patients). Implant failure was assessed using the Henderson classification and outcomes with the Musculoskeletal Tumor Society score. Outcomes were compared with those of a propensity score-matched nononcologic cohort.
Results:
Oncologic patients exhibited higher rates of dislocation (22% vs. 0%), axillary nerve resection (13% vs. 0%), reoperation (52% vs. 10%), and revision surgery (30% vs. 5%) compared with nononcologic patients. Within the oncologic cohort, axillary nerve resection was more frequent in the rTSA-APC group (38% vs. 0%, P = 0.01); no other differences were seen between groups. Two-year dislocation-, reoperation-, and revision-free survival rates were higher in the nononcologic cohort. No differences in survival rates were observed between the rTSA and rTSA-APC groups. Shoulder range of motion was similar between groups. Median Musculoskeletal Tumor Society scores were higher in nononcologic patients compared with oncologic ones (90% vs. 70%; P = 0.001) and in rTSA-APC patients compared with rTSA patients (80% vs. 37%; P = 0.04).
Conclusion:
Oncologic patients overall had more complications and lower functional scores compared with nononcologic patients. Within the oncologic cohort, rTSA-APC patients achieved better functional outcomes than rTSA-only patients, despite experiencing higher complication rates. Surgical approaches should be individualized based on the anatomic defect.
Level Of Evidence:
III.
