Artikel
Endoprosthetics of the shoulder and elbow joints for bone tumors
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Autoren
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Volodymyr Protsenko
- Institute of Traumatology and Orthopedics of NAMS of Ukraine, Kyiv, Ukraine
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Andrii Kukharuk
- Institute of Traumatology and Orthopedics of NAMS of Ukraine, Kyiv, Ukraine
| Veröffentlicht: | 21. Oktober 2024 |
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Gliederung
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Objectives: Malignant bone tumors account for less than 0.2% of all malignant tumors. Treatment of malignant bone tumors is complex. Surgical treatment of bone tumors is the main treatment method for this pathology. One type of surgical treatment for bone tumors is individual endoprosthetics. The use of endoprosthetics in cases of a malignant tumor not only saves the patient’s life, but also preserves a weight-bearing, functioning limb.
Methods: From 2012 to 2023, endoprosthetics of the shoulder and elbow joints for bone tumors was performed on 32 patients. Morphologically we encountered: giant cell tumor – 14 cases, metastatic tumors – 8, chondrosarcoma – 5, osteogenic sarcoma – 4, Ewing’s sarcoma – 1. Endoprosthetics of the shoulder joint was performed in 20 patients, elbow joint – 8, humeral diaphysis – 4. Endoprostheses were used: “Inmed” and “Link”. The functional outcome of the operated limb was calculated using the MSTS scale. Quality of life was determined using the EORTC-QLQ-C30 questionnaire. Patient survival was assessed by the Kaplan-Meier method.
Results and conclusion: Postoperative complications were 9.3%. Tumor recurrence – 3.1%. The functional result of the limb after endoprosthetics of the shoulder joint is 64%, the elbow joint is 76%, and the humeral shaft is 82%. The quality of life of patients after endoprosthetics improved from 40 to 80 points. The overall three-year survival rate was: 82.2±0.14%, five-year survival – 65.8±0.26%.
Complications after endoprosthesis replacement depend on the size of the tumor, the surgical technique of the operation and the design of the endoprosthesis used. The obtained results of shoulder and elbow joint replacement practically coincide with the results of leading oncological orthopedic clinics, such as Mayo (USA). To obtain more effective treatment results, work is needed to improve the designs of endoprostheses and surgical techniques.
Endoprosthetics of the shoulder and elbow joint is a promising area of surgical treatment of bone tumors of the upper limb by improving the functional results of the upper limb and increasing the life expectancy of this category of patients.
