Table 6.
Summary of the data from the recent studies on the use of Allograft Prosthesis Composite for the management of massive skeletal defects in proximal humerus.
| Authors | Diagnosis | No of patients | Mean age (years) | Average Follow up | Clinical outcome | Radiological Outcome (loosening/HO) | Complications | Result | Survival |
|---|---|---|---|---|---|---|---|---|---|
| Ruggieri et.71 | Gorham’s disease | 14 | 35 | 25 m | MSTS = 77 % | – | 2 allograft fracture | 2 revisions | – |
| 1 infection and fracture | |||||||||
| 1 locking mechanism failure | |||||||||
| 1 infection | |||||||||
| 1 allograft fracture | |||||||||
| 1 locking mechanism failure | |||||||||
| Abdeen et al.72 | Osteosarcoma(19), chondrosarcoma(8),oligometastasis(3), others(6) | 36 | 23 | 5 y | MSTS = 26 | 5 superior migration of the humeral head | 1 dislocation | 3 revisions | 88% at 10 years (construct survival) |
| 4 delayed union | |||||||||
| 3 loosening | |||||||||
| 3 prosthetic osteolysis | |||||||||
| Gharedaghi et al.73 | Bone tumors | 102 | 24.5 ± 5.39 | 2 y | – | – | 6 Non-union | – | – |
| 8 Pelvis | 6 allograft fracture | ||||||||
| 12 PF | 8 infection | ||||||||
| 18 SOF | 6 Local recurrence | ||||||||
| 36 DF | 11 metastasis | ||||||||
| 12 PT | 48 limited knee ROM | ||||||||
| 16 humeri | |||||||||
| Black et al.74 | Malignant bone tumors | 6 | 40.7 years | Initial = 25.2y | MSTS = 74% | – | 1 non-union | – | – |
| Second = 55y | 1 implant failure | ||||||||
| Chacon et al.75 | Patient treated with Reverse shoulder arthroplasty | 25 | – | 30.2 m | ASES = 69.4 | 1 Metaphyseal resorption | 2 dislocation | – | – |
| 2 Fragmentation | 1 allograft fracture | ||||||||
| 1 Diaphyseal Resorption | 1 non-displaced acromion fracture | ||||||||
| 4 Non-incorporation | |||||||||
| Dudkiewicz et al.76 | Osteosarcoma | 11 | 17–74 | – | – | – | 2 non-union | 1 death from diseae | – |
| 2 infections | |||||||||
| 1 recurrent instability | |||||||||
| Kassab et al.7 | Malignant bone tumors | 29 | – | 85 m | MSTS = 72.6% massive prosthesis | 11 GH instability | – | – | |
| Lazerges et a.77 | Tumors | 6 | 65.5 | 5.9 y | MSTS = 73% | 2 glenoid notches visible | 1 recurrent instability | 1 revision | – |
| (Reverse APC) | QDASH = 41 | 1 non-union | 1 death from disease | ||||||
| Potter et al.78 | Tumors | 49 | 48.5 | 98 m | MSTS: | DFD: | At 5 years | ||
| 17 OAG | OAG = 71% | – | OAG = 65% | OAG = 7 | OAG = 56% | ||||
| 16 APC | APC = 79% | APC = 44% | APC = 6 | APC = 91% | |||||
| 16 MP | MP = 69% | MP = 44% | MP = 12 | MP = 100% | |||||
| Teunis et al.79 | Tumors | 693 (616 studied) | Sep-57 | Minimum 2 y | FS: | – | Per patient, | – | At 5 years |
| (29 studies) | 143 OAG | ||||||||
| 132 APC | OAG=50–78% | OAG = 0–150% | 33–100% | ||||||
| 341 MP | APC=57–91% | APC = 19–79% | 33–100% | ||||||
| MP=61–77% | MP = 4.5–85% | 38–100% | |||||||
| Wang et al.80 | Tumors | 25 | 48 m | MSTS: | 5 allograft resorption | 10 instability and subluxations | 2 deaths from disease | – | |
| 12 OAG | OAG = 24.58 | 3 MP fractures | |||||||
| 7 APC | APC = 27.00 | ||||||||
| 7 MP | MP = 22.50 |
Abbreviations: m = months, y = years, MSTS = Musculoskeletal Tumor Society Score, ASES Score = American Shoulder and Elbow Surgeons Score, PF = Proximal Femur, SOF = Shaft of Femur, DF = Distal Femur, PT = Proximal Tibia, QDASH = Quick Disabilities of Arm Shoulder and Hand, OAG = Osteoarticular Allograft, APC = Allograft Prosthesis Composite, MP = Megaprosthesis, DFD = Deaths from Disease, FS = Functional Score.