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Pinnamaneni et al. J Cancer Metastasis Treat 2021;7:7 Journal of Cancer
DOI: 10.20517/2394-4722.2020.94 Metastasis and Treatment

Review Open Access

Proximal humerus reconstruction in orthopedic
oncology

Sridhar Pinnamaneni , Timothy A. Damron 2
1
1 Shoulder and Elbow Section, Signature Orthopedics, St. Louis, Missouri 63128, USA.
2 Orthopedic Oncology Section, Upstate Orthopedics, Syracuse, New York 13210, USA.
Correspondence to: Prof. Timothy A. Damron, Orthopedic Oncology Section, Upstate Orthopedics, Syracuse, New York 13210,
USA. E-mail: damront@upstate.edu
How to cite this article: Pinnamaneni S, Damron TA. Proximal humerus reconstruction in orthopedic oncology. J Cancer Metastasis
Treat 2021;7:7. http://dx.doi.org/10.20517/2394-4722.2020.94
Received: 2 Sep 2020 First Decision: 15 Oct 2020 Revised: 26 Oct 2020 Accepted: 24 Nov 2020 Published: 3 Feb 2021

Academic Editor: Ian Judson Copy Editor: Whitney Xu Production Editor: Jing Yu

Abstract
Proximal humeral reconstructive options following radical resection of proximal humeral primary and metastatic
bone malignancies have evolved over time. With the relatively recent advent of the reverse total shoulder (RTSA),
this technique has been increasingly employed in this setting over hemiarthroplasty techniques. An array of
options, including proximal humeral allograft-prosthetic composites (including both RTSA and hemiarthroplasty),
megaprostheses, and osteoarticular allografts, is reviewed from the perspective of their indications, techniques,
complications, and published results. An extensive case-based pictorial presentation illustrates these options.

Keywords: Proximal humerus, oncology, primary bone tumor, metastatic disease, endoprosthesis, allograft

INTRODUCTION
[1,2]
The proximal humerus is a common site for metastatic and primary bone tumors . With the evolution of
chemotherapeutics, radiotherapy, and advanced imaging techniques, limb salvage surgery has become the
norm in this location except for very advanced cases. Tumors in this region impose significant challenges
for local control, reconstruction, and function. Potential glenohumeral joint involvement and close
proximity of neurovascular structures affects local control and function, while lack of intrinsic stability and
dependence on dynamic and static stabilizers affects reconstruction and function. Resection for metastatic
disease may require bone-only resection, but restoration of soft-tissue attachments and glenohumeral

© The Author(s) 2021. Open Access This article is licensed under a Creative Commons Attribution 4.0
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