BACKGROUND: In recent years, there has been growing interest in the use of reverse total shoulder arthroplasty (rTSA) for reconstruction of the proximal humerus after oncologic resection. However, the indications and outcomes of oncologic rTSA remain unclear. METHODS: We conducted a systematic review to identify studies that reported outcomes of patients who underwent rTSA for oncologic reconstruction of the proximal humerus. Extracted data included demographics, indications, operative techniques, outcomes, and complications. Weighted means were calculated according to sample size. RESULTS: Twelve studies were included, containing 194 patients who underwent rTSA for oncologic reconstruction of the proximal humerus. Mean patient age was 48 years, and 52% were male. Primary malignancies were present in 55% of patients, metastatic disease 30%, and benign tumors 9%. Mean humeral resection length was 12cm. Mean postoperative MSTS score was 78%, Constant score 60, and TESS score 77%. Mean complication rate was 28%, with shoulder instability accounting for 63% of complications. Revisions were performed in 16% of patients, and mean implant survival was 89% at a mean follow-up across studies of 53 months. CONCLUSIONS: Although the existing literature is of poor study quality, with a high level of heterogeneity and risk of bias, rTSA appears to be a suitable option in appropriately selected patients undergoing oncologic resection and reconstruction of the proximal humerus. The most common complication is instability. Higher quality evidence is needed to help guide decision making on appropriate implant utilization for patients undergoing oncologic resection of the proximal humerus.
BACKGROUND: In recent years, there has been growing interest in the use of reverse total shoulder arthroplasty (rTSA) for reconstruction of the proximal humerus after oncologic resection. However, the indications and outcomes of oncologic rTSA remain unclear. METHODS: We conducted a systematic review to identify studies that reported outcomes of patients who underwent rTSA for oncologic reconstruction of the proximal humerus. Extracted data included demographics, indications, operative techniques, outcomes, and complications. Weighted means were calculated according to sample size. RESULTS: Twelve studies were included, containing 194 patients who underwent rTSA for oncologic reconstruction of the proximal humerus. Mean patient age was 48 years, and 52% were male. Primary malignancies were present in 55% of patients, metastatic disease 30%, and benign tumors 9%. Mean humeral resection length was 12cm. Mean postoperative MSTS score was 78%, Constant score 60, and TESS score 77%. Mean complication rate was 28%, with shoulder instability accounting for 63% of complications. Revisions were performed in 16% of patients, and mean implant survival was 89% at a mean follow-up across studies of 53 months. CONCLUSIONS: Although the existing literature is of poor study quality, with a high level of heterogeneity and risk of bias, rTSA appears to be a suitable option in appropriately selected patients undergoing oncologic resection and reconstruction of the proximal humerus. The most common complication is instability. Higher quality evidence is needed to help guide decision making on appropriate implant utilization for patients undergoing oncologic resection of the proximal humerus.