Skip to main content
Erschienen in: International Orthopaedics 2/2017

09.11.2016 | Original Paper

Silver-coated endoprosthetic replacement of the proximal humerus in case of tumour—is there an increased risk of periprosthetic infection by using a trevira tube?

verfasst von: Jan Schmolders, Sebastian Koob, Paul Schepers, Michael Kehrer, Sönke Percy Frey, Dieter Christian Wirtz, Peter Heinrich Pennekamp, Andreas Christian Strauss

Erschienen in: International Orthopaedics | Ausgabe 2/2017

Einloggen, um Zugang zu erhalten

Abstract

Background and objectives

The aim of our study was to evaluate if there is an increased risk of periprosthetic infection (PJI) in patients following replacement of the proximal humerus by using a modular tumour prosthesis in combination with a trevira tube.

Methods

Thirty patients were treated by using a modular tumour endoprosthesis (MUTARS®) following intra-articular resection of the proximal humerus. Fifteen patients received treatment by using a trevira tube. In 15 further cases the use of a trevira tube was not necessary. The mean follow-up time was 26 months (range: 24 months to 84 months). Both, Enneking score and range of motion (ROM), was evaluated. Further radiographs were obtained in two planes.

Results

The survival rate one year after surgery was 83 % and 63 % after two years. We recorded a 96 % survival of the limb two years after surgery. We also observed only one case of periprosthetic joint infection (PJI) in the entire follow-up period in one patient who received treatment with a trevira tube. The mean Enneking score was 20 points (range 8 to 26 points). ROM was equal in both study groups. In total 20 % of the treated patients (n = 6) suffered complications.

Conclusions

Replacement of the proximal humerus by using a trevira tube in combination with a modular tumour endoprosthesis is a safe and viable treatment option for both, bone tumours and metastases. There is no statistically significant increased risk of infection by using trevira tube even among immunosuppressed patients.

Level of evidence

Level 3, retrospective comparative study
Literatur
2.
Zurück zum Zitat Mittermayer F, Krepler P, Dominkus M, Schwameis E, Sluga M, Heinzl H, Kotz R (2001) Long-term followup of uncemented tumor endoprostheses for the lower extremity. Clinical orthopaedics and related research:167–177 Mittermayer F, Krepler P, Dominkus M, Schwameis E, Sluga M, Heinzl H, Kotz R (2001) Long-term followup of uncemented tumor endoprostheses for the lower extremity. Clinical orthopaedics and related research:167–177
3.
Zurück zum Zitat Sluga M, Windhager R, Lang S, Heinzl H, Bielack S, Kotz R (1999) Local and systemic control after ablative and limb sparing surgery in patients with osteosarcoma. Clin Orthop Relat Res:120–127 Sluga M, Windhager R, Lang S, Heinzl H, Bielack S, Kotz R (1999) Local and systemic control after ablative and limb sparing surgery in patients with osteosarcoma. Clin Orthop Relat Res:120–127
7.
9.
Zurück zum Zitat Nelson GN, Davis DE, Namdari S (2016) Outcomes in the treatment of periprosthetic joint infection after shoulder arthroplasty: a systematic review. J Should Elbow Surg/Am Should Elbow Surg. doi:10.1016/j.jse.2015.11.064 Nelson GN, Davis DE, Namdari S (2016) Outcomes in the treatment of periprosthetic joint infection after shoulder arthroplasty: a systematic review. J Should Elbow Surg/Am Should Elbow Surg. doi:10.​1016/​j.​jse.​2015.​11.​064
10.
Zurück zum Zitat Gosheger G, Winkelmann W (2000) Mutars--a modular tumor- and revision system. Experiences at the Munster Tumor Center. Orthopade 29(Suppl 1):S54–55CrossRefPubMed Gosheger G, Winkelmann W (2000) Mutars--a modular tumor- and revision system. Experiences at the Munster Tumor Center. Orthopade 29(Suppl 1):S54–55CrossRefPubMed
11.
Zurück zum Zitat Gosheger G, Hardes J, Ahrens H, Gebert C, Winkelmann W (2005) Endoprosthetic replacement of the humerus combined with trapezius and latissimus dorsi transfer: a report of three patients. Arch Orthop Trauma Surg 125:62–65. doi:10.1007/s00402-004-0713-2 CrossRefPubMed Gosheger G, Hardes J, Ahrens H, Gebert C, Winkelmann W (2005) Endoprosthetic replacement of the humerus combined with trapezius and latissimus dorsi transfer: a report of three patients. Arch Orthop Trauma Surg 125:62–65. doi:10.​1007/​s00402-004-0713-2 CrossRefPubMed
12.
Zurück zum Zitat Enneking W, Dunham W, Gebhardt M, Malawar M, Pritchard D (1990) A system for the classification of skeletal resections. La Chirurgia degli Organi di Movimento 75:217–240PubMed Enneking W, Dunham W, Gebhardt M, Malawar M, Pritchard D (1990) A system for the classification of skeletal resections. La Chirurgia degli Organi di Movimento 75:217–240PubMed
13.
Zurück zum Zitat Charlson ME, Pompei P, Ales KL, MacKenzie CR (1987) A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis 40:373–383CrossRefPubMed Charlson ME, Pompei P, Ales KL, MacKenzie CR (1987) A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis 40:373–383CrossRefPubMed
14.
Zurück zum Zitat Rodl RW, Gosheger G, Gebert C, Lindner N, Ozaki T, Winkelmann W (2002) Reconstruction of the proximal humerus after wide resection of tumours. J Bone Joint Surg (Br) 84:1004–1008CrossRef Rodl RW, Gosheger G, Gebert C, Lindner N, Ozaki T, Winkelmann W (2002) Reconstruction of the proximal humerus after wide resection of tumours. J Bone Joint Surg (Br) 84:1004–1008CrossRef
15.
Zurück zum Zitat Wada T, Usui M, Isu K, Yamawakii S, Ishii S (1999) Reconstruction and limb salvage after resection for malignant bone tumour of the proximal humerus. A sling procedure using a free vascularised fibular graft. J Bone Joint Surg (Br) 81:808–813CrossRef Wada T, Usui M, Isu K, Yamawakii S, Ishii S (1999) Reconstruction and limb salvage after resection for malignant bone tumour of the proximal humerus. A sling procedure using a free vascularised fibular graft. J Bone Joint Surg (Br) 81:808–813CrossRef
16.
Zurück zum Zitat Enneking WF, Eady JL, Burchardt H (1980) Autogenous cortical bone grafts in the reconstruction of segmental skeletal defects. J Bone Joint Surg Am 62:1039–1058CrossRefPubMed Enneking WF, Eady JL, Burchardt H (1980) Autogenous cortical bone grafts in the reconstruction of segmental skeletal defects. J Bone Joint Surg Am 62:1039–1058CrossRefPubMed
17.
Zurück zum Zitat Getty PJ, Peabody TD (1999) Complications and functional outcomes of reconstruction with an osteoarticular allograft after intra-articular resection of the proximal aspect of the humerus. J Bone Joint Surg Am 81:1138–1146CrossRefPubMed Getty PJ, Peabody TD (1999) Complications and functional outcomes of reconstruction with an osteoarticular allograft after intra-articular resection of the proximal aspect of the humerus. J Bone Joint Surg Am 81:1138–1146CrossRefPubMed
18.
Zurück zum Zitat Rodl RW, Ozaki T, Hoffmann C, Bottner F, Lindner N, Winkelmann W (2000) Osteoarticular allograft in surgery for high-grade malignant tumours of bone. J Bone Joint Surg (Br) 82:1006–1010CrossRef Rodl RW, Ozaki T, Hoffmann C, Bottner F, Lindner N, Winkelmann W (2000) Osteoarticular allograft in surgery for high-grade malignant tumours of bone. J Bone Joint Surg (Br) 82:1006–1010CrossRef
19.
Zurück zum Zitat Kumar D, Grimer RJ, Abudu A, Carter SR, Tillman RM (2003) Endoprosthetic replacement of the proximal humerus. Long-term results. J Bone Joint Surg (Br) 85:717–722 Kumar D, Grimer RJ, Abudu A, Carter SR, Tillman RM (2003) Endoprosthetic replacement of the proximal humerus. Long-term results. J Bone Joint Surg (Br) 85:717–722
20.
Zurück zum Zitat Ross AC, Sneath RS, Scales JT (1987) Endoprosthetic replacement of the humerus and elbow joint. J Bone Joint Surg (Br) 69:652–655 Ross AC, Sneath RS, Scales JT (1987) Endoprosthetic replacement of the humerus and elbow joint. J Bone Joint Surg (Br) 69:652–655
21.
Zurück zum Zitat Malawer MM, Chou LB (1995) Prosthetic survival and clinical results with use of large-segment replacements in the treatment of high-grade bone sarcomas. J Bone Joint Surg Am 77:1154–1165CrossRefPubMed Malawer MM, Chou LB (1995) Prosthetic survival and clinical results with use of large-segment replacements in the treatment of high-grade bone sarcomas. J Bone Joint Surg Am 77:1154–1165CrossRefPubMed
23.
Zurück zum Zitat Asavamongkolkul A, Waikakul S, Phimolsarnti R, Kiatisevi P, Wangsaturaka P (2007) Endoprosthetic reconstruction for malignant bone and soft-tissue tumors. J Med Assoc Thai 90:706–717PubMed Asavamongkolkul A, Waikakul S, Phimolsarnti R, Kiatisevi P, Wangsaturaka P (2007) Endoprosthetic reconstruction for malignant bone and soft-tissue tumors. J Med Assoc Thai 90:706–717PubMed
25.
26.
Zurück zum Zitat Bos G, Sim F, Pritchard D, Shives T, Rock M, Askew L, Chao E (1987) Prosthetic replacement of the proximal humerus. Clin Orthop Relat Res:178–191 Bos G, Sim F, Pritchard D, Shives T, Rock M, Askew L, Chao E (1987) Prosthetic replacement of the proximal humerus. Clin Orthop Relat Res:178–191
27.
Zurück zum Zitat Jensen KL, Johnston JO (1995) Proximal humeral reconstruction after excision of a primary sarcoma. Clin Orthop Relat Res:164–175 Jensen KL, Johnston JO (1995) Proximal humeral reconstruction after excision of a primary sarcoma. Clin Orthop Relat Res:164–175
28.
Zurück zum Zitat Mankin HJ, Gebhardt MC, Jennings LC, Springfield DS, Tomford WW (1996) Long-term results of allograft replacement in the management of bone tumors. Clin Orthop Relat Res:86–97 Mankin HJ, Gebhardt MC, Jennings LC, Springfield DS, Tomford WW (1996) Long-term results of allograft replacement in the management of bone tumors. Clin Orthop Relat Res:86–97
29.
Zurück zum Zitat Ross AC, Wilson JN, Scales JT (1987) Endoprosthetic replacement of the proximal humerus. J Bone Joint Surg (Br) 69:656–661 Ross AC, Wilson JN, Scales JT (1987) Endoprosthetic replacement of the proximal humerus. J Bone Joint Surg (Br) 69:656–661
Metadaten
Titel
Silver-coated endoprosthetic replacement of the proximal humerus in case of tumour—is there an increased risk of periprosthetic infection by using a trevira tube?
verfasst von
Jan Schmolders
Sebastian Koob
Paul Schepers
Michael Kehrer
Sönke Percy Frey
Dieter Christian Wirtz
Peter Heinrich Pennekamp
Andreas Christian Strauss
Publikationsdatum
09.11.2016
Verlag
Springer Berlin Heidelberg
Erschienen in
International Orthopaedics / Ausgabe 2/2017
Print ISSN: 0341-2695
Elektronische ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-016-3329-6

Weitere Artikel der Ausgabe 2/2017

International Orthopaedics 2/2017 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.