Proximal humeral replacement using a fixed-fulcrum endoprosthesis

D Griffiths, P D Gikas, C Jowett, L Bayliss, W Aston, J Skinner, S Cannon, G Blunn, T W R Briggs, R Pollock

Research output: Contribution to journalArticlepeer-review


Between 1997 and 2007, 68 consecutive patients underwent replacement of the proximal humerus for tumour using a fixed-fulcrum massive endoprosthesis. Their mean age was 46 years (7 to 87). Ten patients were lost to follow-up and 16 patients died. The 42 surviving patients were assessed using the Musculoskeletal Tumor Society (MSTS) Score and the Toronto Extremity Salvage Score (TESS) at a mean follow-up of five years and 11 months (one year to ten years and nine months). The mean MSTS score was 72.3% (53.3% to 100%) and the mean TESS was 77.2% (58.6% to 100%). Four of 42 patients received a new constrained humeral liner to reduce the risk of dislocation. This subgroup had a mean MSTS score of 77.7% and a mean TESS of 80.0%. The dislocation rate for the original prosthesis was 25.9; none of the patients with the new liner had a dislocation at a mean of 14.5 months (12 to 18). Endoprosthetic replacement for tumours of the proximal humerus using this prosthesis is a reliable operation yielding good results without the documented problems of unconstrained prostheses. The performance of this prosthesis is expected to improve further with a new constrained humeral liner, which reduces the risk of dislocation.

Original languageEnglish
Pages (from-to)399-403
Number of pages5
JournalJournal of Bone and Joint Surgery - British Volume
Issue number3
Publication statusPublished - Mar 2011


  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Arthroplasty, Replacement
  • Bone Neoplasms
  • Child
  • Humans
  • Humerus
  • Joint Prosthesis
  • Middle Aged
  • Neoplasm Recurrence, Local
  • Prosthesis Design
  • Shoulder Joint
  • Treatment Outcome
  • Young Adult
  • Evaluation Studies


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