Hemiarthroplasty as management for solitary metastasis of the proximal humerus: a retrospective study

Advances in cancer treatment have prolonged survival, but the incidence of bone metastases has also increased. Shoulder arthroplasty for proximal humeral metastases involves major surgical trauma and uncertain functional outcomes in older patients. This study aimed to assess whether age influences prognosis and functional recovery after shoulder arthroplasty.

Fifty-three patients with isolated proximal humeral metastases undergoing arthroplasty were retrospectively reviewed. Patients were divided into Group A (≥65 years, n = 25) and Group B (<65 years, n = 28). Surgical outcomes were compared between groups, including operative time, blood loss, hospital stay, pain, limb function, complications, survival, recurrence, and quality of life. Statistical analyses included ANOVA, chi-square tests, and Cox regression to identify prognostic factors.

Operative time, intraoperative blood loss, hospital stay, Visual Analogue Scale, Musculoskeletal Tumor Society scores, complication rates, survival, recurrence, and metastasis showed no significant group differences (p > 0.05). However, American Shoulder and Elbow Surgeons scores were significantly different (p < 0.05). Cox regression identified tumor malignancy and hospital stay as independent risk factors (p < 0.05), while age was not prognostic (p > 0.05).

Older patients achieved survival, functional recovery, and complication rates comparable to younger patients. Prosthetic humeral head replacement is therefore a viable treatment option for isolated proximal humeral metastases in older patients.