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Factors influencing outcomes of endoprosthetic reconstruction of the distal end of the humerus

Chebli, Caroline M., MDa; Crimi, Alberto, MDb; Letson, Douglas, MDc; Binitie, Odion, MDc

doi: 10.1097/BCO.0000000000000728
ORIGINAL RESEARCH
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Background: Reconstruction of the distal humerus with modular endoprostheses is an uncommon procedure. We report the outcomes from a single institution of distal humeral reconstructions with a modular endoprosthesis.

Methods: A retrospective chart review of our database from 1/1/2001-12/31/2016 identified 20 patients who received a distal humeral endoprosthesis. The time to failure, type of failure, and final range of motion were evaluated. Comparisons were made between primary and revision endoprostheses. The relationship between resection level, range of motion, and time to failure were evaluated.

Results: The average age was 69.9 yr with equal numbers of males and females. There were 13 primary and seven revision surgeries. The average follow-up was 40.9 mo. Eight patients experienced a failure requiring further surgical treatment: three soft tissue, two aseptic loosening, two infections and one tumor progression. The average range of motion was 65.86 degrees. The average resection length was 12.86 cm. Kaplan-Meier analysis showed no difference between failure or time to failure in primary versus revision procedures. There was a lower chance of failure with a resection level greater than 12 cm. There was no difference in range of motion and resection level.

Conclusions: Distal humeral endoprostheses provide stable constructs in limb preserving surgeries. The complication profile is higher than standard total elbows. There was no difference in failures or time to failure between primary and revision surgeries. The major limitation of this study was the limited number of patients. It is one of the larger series evaluating distal humeral replacements.

aJames A. Haley VA Medical Center, Tampa, FL

bUniversity of Padova, Italy

cMoffitt Cancer Center, Tampa, FL

IRB: CR6_107894 University of South Florida, research Integrity and Compliance, Institutional Review Boards, FWA no. 00001669

Financial Disclosures: Dr. Letson is a paid consultant for Stryker. The other authors have no disclosures. The authors report no conflicts of interest in regard to this work.

Correspondence to Caroline M. Chebli, MD, James A. Haley Medical Center, Tampa, FL 33612 Tel: +206-459-3207; fax: +941-445-4152; e-mail: carolinechebli@gmail.com.

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