Optimized prosthetic design, surgical technique, and cosmetic outcome in shoulder reconstruction with double-constrained implant following extra-articular shoulder resection: a proof-of-concept
Abstract Reconstruction of the anatomic defect following extra-articular shoulder resection is a challenging problem, particularly in cases when function of the deltoid muscle and rotator cuff are compromised. Standard reconstruction techniques often result in either instability or rigidity. Constra...
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| Format: | Article |
| Language: | English |
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BMC
2025-05-01
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| Series: | World Journal of Surgical Oncology |
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| Online Access: | https://doi.org/10.1186/s12957-025-03844-9 |
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| author | Jan Lesensky Michal Benes Martin Havranek Ana C. Belzarena |
| author_facet | Jan Lesensky Michal Benes Martin Havranek Ana C. Belzarena |
| author_sort | Jan Lesensky |
| collection | DOAJ |
| description | Abstract Reconstruction of the anatomic defect following extra-articular shoulder resection is a challenging problem, particularly in cases when function of the deltoid muscle and rotator cuff are compromised. Standard reconstruction techniques often result in either instability or rigidity. Constrained implants have been used to overcome these problems; however, they have been associated with a high rate of aseptic loosening. Recently, a novel double-constrained implant has been introduced, yielding promising functional results. Nonetheless, this implant exhibited a cosmetic defect related to protrusion of the humeral component that becomes apparent with time as result of surrounding muscle atrophy. An updated improved design of the implant has been developed to counteract this. We report the case of a 15-year-old patient who underwent an extra-articular (Malawer type V) shoulder resection due to osteosarcoma and received an innovated custom-made double-constrained implant. Moreover, we describe a new modification of the Malawer utilitarian approach to the shoulder girdle that enhances tumor visibility and allows safer dissection. The patient recovered well with satisfactory outcomes at 18 months follow-up, highlighting the potential benefits of this implant design and surgical approach. |
| format | Article |
| id | doaj-art-c58effa2ed45445c8b67ec4f26f27479 |
| institution | OA Journals |
| issn | 1477-7819 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | BMC |
| record_format | Article |
| series | World Journal of Surgical Oncology |
| spelling | doaj-art-c58effa2ed45445c8b67ec4f26f274792025-08-20T02:32:04ZengBMCWorld Journal of Surgical Oncology1477-78192025-05-012311710.1186/s12957-025-03844-9Optimized prosthetic design, surgical technique, and cosmetic outcome in shoulder reconstruction with double-constrained implant following extra-articular shoulder resection: a proof-of-conceptJan Lesensky0Michal Benes1Martin Havranek2Ana C. Belzarena3Department of Orthopaedics, First Faculty of Medicine, Charles University and University Hospital Na Bulovce1st Department of Orthopaedics, First Faculty of Medicine, Charles University and Motol University HospitalFaculty of Mechanical Engineering, Czech Technical UniversityDepartment of Orthopaedic Surgery, University of MissouriAbstract Reconstruction of the anatomic defect following extra-articular shoulder resection is a challenging problem, particularly in cases when function of the deltoid muscle and rotator cuff are compromised. Standard reconstruction techniques often result in either instability or rigidity. Constrained implants have been used to overcome these problems; however, they have been associated with a high rate of aseptic loosening. Recently, a novel double-constrained implant has been introduced, yielding promising functional results. Nonetheless, this implant exhibited a cosmetic defect related to protrusion of the humeral component that becomes apparent with time as result of surrounding muscle atrophy. An updated improved design of the implant has been developed to counteract this. We report the case of a 15-year-old patient who underwent an extra-articular (Malawer type V) shoulder resection due to osteosarcoma and received an innovated custom-made double-constrained implant. Moreover, we describe a new modification of the Malawer utilitarian approach to the shoulder girdle that enhances tumor visibility and allows safer dissection. The patient recovered well with satisfactory outcomes at 18 months follow-up, highlighting the potential benefits of this implant design and surgical approach.https://doi.org/10.1186/s12957-025-03844-9Double-constrained implantExtra-articular resectionMalawer type V resectionShoulder reconstructionOsteosarcoma |
| spellingShingle | Jan Lesensky Michal Benes Martin Havranek Ana C. Belzarena Optimized prosthetic design, surgical technique, and cosmetic outcome in shoulder reconstruction with double-constrained implant following extra-articular shoulder resection: a proof-of-concept World Journal of Surgical Oncology Double-constrained implant Extra-articular resection Malawer type V resection Shoulder reconstruction Osteosarcoma |
| title | Optimized prosthetic design, surgical technique, and cosmetic outcome in shoulder reconstruction with double-constrained implant following extra-articular shoulder resection: a proof-of-concept |
| title_full | Optimized prosthetic design, surgical technique, and cosmetic outcome in shoulder reconstruction with double-constrained implant following extra-articular shoulder resection: a proof-of-concept |
| title_fullStr | Optimized prosthetic design, surgical technique, and cosmetic outcome in shoulder reconstruction with double-constrained implant following extra-articular shoulder resection: a proof-of-concept |
| title_full_unstemmed | Optimized prosthetic design, surgical technique, and cosmetic outcome in shoulder reconstruction with double-constrained implant following extra-articular shoulder resection: a proof-of-concept |
| title_short | Optimized prosthetic design, surgical technique, and cosmetic outcome in shoulder reconstruction with double-constrained implant following extra-articular shoulder resection: a proof-of-concept |
| title_sort | optimized prosthetic design surgical technique and cosmetic outcome in shoulder reconstruction with double constrained implant following extra articular shoulder resection a proof of concept |
| topic | Double-constrained implant Extra-articular resection Malawer type V resection Shoulder reconstruction Osteosarcoma |
| url | https://doi.org/10.1186/s12957-025-03844-9 |
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