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- Talk
- 22/09/2021
- UK
Tumours of the Proximal Humerus : A Tertiary Referral Centre Experience
Description
In this presentation, Varunprasanth Sethurajah discusses the management of upper limb malignancies, specifically focusing on tumors of the proximal humerus. He emphasizes the humerus as a common site for both primary bone sarcomas and metastases, underlining the need for effective medical strategies to support patients' quality of life due to their dependence on upper limb functionality. Varun outlines the various surgical interventions historically used for these tumors, such as IM Nails, plating, vascularized fibular grafts, and endoprosthetic replacements. He highlights the importance of addressing the long-term needs of patients, especially as they often outlive their surgical implants, necessitating durable solutions.
The presentation details the evolution of shoulder implants, discussing first, second, and third-generation designs. The first-generation implant, the Oxford Hemiarthroplasty, relies primarily on a long stem and cement-bone interface which offers limited soft tissue integration. The second-generation Stanmore Implant improves on this with a larger design that incorporates hydroxyapatite coating and drill holes for better bone integration.
Varun then introduces third-generation implants, which are typically 3D-printed and customized to individual patient anatomy, enhancing soft tissue attachment capabilities. He provides a comprehensive analysis of their clinical study, including patient demographics, types of malignancies treated, functional outcomes based on the Oxford Shoulder Score, and improvements noted with third-generation implants compared to earlier designs.
He concludes that while the newer implants yield better functional results, challenges related to sample size, follow-up duration, and variations in preoperative assessments remain. The ultimate aim is achieving complete tumor resection while ensuring that patients can expect significant functional recovery post-surgery. Varun acknowledges contributions from his co-authors and references supporting his work.