Silver-coated endoprosthetic replacement of the proximal humerus in case of tumour-is there an increased risk of periprosthetic infection by using a trevira tube?

BACKGROUND AND

OBJECTIVES

The aim of our study was to evaluate if there is an increased risk of periprosthetic infection (PJI) in patients following replacement of the proximal humerus by using a modular tumour prosthesis in combination with a trevira tube.

METHODS

Thirty patients were treated by using a modular tumour endoprosthesis (MUTARS®) following intra-articular resection of the proximal humerus. Fifteen patients received treatment by using a trevira tube. In 15 further cases the use of a trevira tube was not necessary. The mean follow-up time was 26 months (range: 24 months to 84 months). Both, Enneking score and range of motion (ROM), was evaluated. Further radiographs were obtained in two planes.

RESULTS

The survival rate one year after surgery was 83 % and 63 % after two years. We recorded a 96 % survival of the limb two years after surgery. We also observed only one case of periprosthetic joint infection (PJI) in the entire follow-up period in one patient who received treatment with a trevira tube. The mean Enneking score was 20 points (range 8 to 26 points). ROM was equal in both study groups. In total 20 % of the treated patients (n = 6) suffered complications.

CONCLUSIONS

Replacement of the proximal humerus by using a trevira tube in combination with a modular tumour endoprosthesis is a safe and viable treatment option for both, bone tumours and metastases. There is no statistically significant increased risk of infection by using trevira tube even among immunosuppressed patients.

LEVEL OF EVIDENCE: Level 3, retrospective comparative study.