Sadegh Saberi - Orthopedic Tumor Surgeon Tehran University of Medical sciences

Limb salvage following resection of a tumor around shoulder especially in proximalhumerus poses many challenges. Reconstructive options are limited because of the loss of periarticular soft-tissue stabilizers of the glenohumeral joint in addition to theloss of bone and articular cartilage. In the adult patient functional reconstructionafter transarticular proximal humeral resection is most frequently performed usingosteoarticular allograft (OA) as biologic reconstruction or endoprosthesis (EP) or acombination of both (APC). The use of allograft is frequently promoted for restorationof bone stock and anatomical reconstruction of soft tissues. Some studies have statedthat this anatomical repair resulted in better postoperative function and glenohumeralstability .In contrast, chondrolysis, allograft fracture, infection and non-union havealso been introduced as reasons not to consider OA for standalone proximal humeralreconstruction. Use of a cement into the allograft, preferably bridging the allograftand fixed into the healthy autologous humeral bone with compression techniques,should prevent chondrolysis and allograft fracture but are still susceptible to nonunion,osteolysis and loosening.Because of high rate of mechanical complication OAis not the choice option forproximal humerus reconstruction however the cost incomparison to Prosthesis set it as attractive option in some countries.