Department of Orthopaedic Oncology, The Royal Orthopaedic Hospital, Birmingham, UK.
Department of Orthopaedic Oncology, The Royal Orthopaedic Hospital, Birmingham, UK.
J Shoulder Elbow Surg. 2017 Nov;26(11):1990-1994. doi: 10.1016/j.jse.2017.04.005. Epub 2017 Jul 3.
The Bayley Walker (Stanmore Implants, Elstree, UK) reversed polarity, linked shoulder replacement is designed to provide stable function in the treatment of a painful shoulder with poor soft tissue coverage. We reviewed the results of the prosthesis in destructive pathologic lesions of the proximal humerus at a United Kingdom tumor center.
We identified 8 patients (2 men, 6 women) in our database. Clinical information and functional outcome scores were collected, including range of movement, Toronto Extremity Salvage Score, the Musculoskeletal Tumor Score. Radiographs from the last clinic follow-up were analyzed.
Of the 8 patients, 2 were revisions for aseptic loosening around proximal humeral endoprosthetic replacements. Indications for surgery included chondrosarcoma in 4, metastatic disease in 2, Ewing sarcoma in 1, and osteomyelitis in 1. Patients were a mean age at diagnosis of 49 years (range, 16-78 years). One patient died of metastatic disease during follow-up. Mean follow-up was 49 months (range, 36-90 months). At the latest follow-up, there was 100% survivorship using revision as the end point. There were no local recurrences. Three of 5 patients returned to their previous occupation. Neuropathic pain developed in 1 patient postoperatively, but no other postoperative complications were noted. Radiographs showed no progressive lucencies or scapula notching. Mean range of movement at final follow-up was abduction, 62°; forward flexion, 71°; and external and internal rotation, 50°.
The Bayley Walker prosthesis gives excellent medium-term survivorship and pain relief in patients with pathologic lesions of the proximal humerus requiring wide local excision.
Bayley Walker（英国 Stanmore Implants，Elstree）反向极性、连接肩置换旨在为软组织覆盖不良的疼痛性肩部提供稳定的功能。我们回顾了英国肿瘤中心近端肱骨破坏性病理病变中假体的结果。
我们在数据库中确定了 8 名患者（2 名男性，6 名女性）。收集了临床信息和功能结果评分，包括运动范围、多伦多肢体挽救评分、肌肉骨骼肿瘤评分。分析了最后一次临床随访时的 X 光片。
8 名患者中，有 2 名是因近端肱骨内置假体周围无菌性松动而进行的翻修。手术指征包括软骨肉瘤 4 例、转移性疾病 2 例、尤文肉瘤 1 例、骨髓炎 1 例。患者诊断时的平均年龄为 49 岁（范围，16-78 岁）。1 例患者在随访期间死于转移性疾病。平均随访时间为 49 个月（范围，36-90 个月）。截至最新随访时，以翻修为终点，生存率为 100%。无局部复发。5 例患者中有 3 例恢复到以前的职业。1 例患者术后出现神经病理性疼痛，但未发现其他术后并发症。X 光片显示无进行性透亮或肩胛骨切迹。最终随访时的平均运动范围为外展 62°；前屈 71°；外旋和内旋 50°。
Bayley Walker 假体在需要广泛局部切除的近端肱骨病理性病变患者中提供了出色的中期生存率和疼痛缓解。
