(P 267) LONG-TERM FUNCTIONAL OUTCOMES OF SHOULDER ARTHRODESIS FOR TUMOR RESECTION

Objective: Shoulder arthrodesis is a demanding surgical procedure. However, it is an option for reconstruction of the glenohumeral joint following an oncologic resection, especially for patients in whom the axillary nerve is compromised. Advances in implant design have influenced reconstructive options following oncologic resection of shoulder girdle tumors.

Methods: We reviewed 18 shoulder arthrodeses (10 primary and 8 revision) for management of shoulder girdle neoplasms. The group included 11 males with the most common diagnosis of osteosarcoma (n=9). Method of arthrodesis was fibrometal implant in three patients and allograft alone in 13 patients. The remaining 2 patients did not have accessible implant records. The mean follow-up was 20 years.

Results: Mean Musculoskeletal Tumor Society Scores and Toronto Extremity Salvage Scores at final follow-up were 73% and 88% respectively. Six (33%) patients had post operative complications requiring revision surgery. The three fibrometal arthrodeses were complicated by loosening, all within three years. One patient developed infected hardware at 25 years post-op, otherwise there were no complications beyond 5 years. Two patients demonstrated local recurrence of their tumor, and one of these patients developed metastatic disease. Recurrence was treated with chemotherapy in both cases. No other patients were diagnosed with metastatic disease.

Conclusion: Shoulder arthrodesis provides satisfactory long-term outcomes for primary and secondary management of shoulder girdle tumors; however, complication rates remain high. Most complications occur within the first 3-5 years of the index fusion.