Replacement of the proximal humerus with a ceramic prosthesis: a preliminary report

Insertion of a multicomponent ceramic prosthesis with extracortical fixation to the conically reamed shaft of the humerus was performed in 7 patients after resection of 4 malignant and 3 benign tumors of the proximal humerus. The length of the replacement ranged from 9 to 18 cm. Fixation was secure in all but one patient, who sustained a fracture through the proximal humerus. Subluxation occurred in 3 patients but posed no difficulty, except in one patient who required revision for a dislocation. Functionally, little active motion is achieved, but the implant provides a spacer to permit efficient use of the hand and elbow. No patient has had local recurrence of the tumor. One patient died one year postoperatively from an unrelated second primary cancer. Although the preliminary results are encouraging, further investigations are necessary on the mechanical aspects of the cone fixation principle and of the techniques of shoulder muscle reconstruction to improve the function of the prosthetic joint.