Evidence map›Paper›PMID 40518134›Full record

ArticleBone & joint open2025

Proximal humeral endoprosthetic reconstruction for tumour defects : clinical outcomes of 165 patients from the MUTARS Orthopedic Registry Orthopedic Registry Europe (MORE).

Richard Evenhuis, Michaël P A Bus, Simen Sellevold, Edwin F Dierselhuis, Ioannis G Trikoupis, Maurizio Scorianz, Sebastian Walter, Jorge Cabrolier, Marta Fiocco, Michiel A J van de Sande and 1 more

Abstract read
In one paragraph

Article in Bone & joint open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Richard EvenhuisDepartment of Orthopaedic Surgery, Leiden University Medical Center, Leiden, Netherlands.
Michaël P A BusDepartment of Orthopaedic Surgery, Leiden University Medical Center, Leiden, Netherlands.
Simen SellevoldDepartment of Orthopedic Surgery, Oslo University Hospital, Oslo, Norway.
Edwin F DierselhuisDepartment of Orthopaedic Surgery, Radboudumc, Nijmegen, Netherlands.
Ioannis G TrikoupisFirst Department of Orthopaedic Surgery, National and Kapodistrian University of Athens, Attikon University General Hospital, Rimini, Greece.
Maurizio ScorianzDepartment of Orthopaedic Oncology, University Hospital Careggi, Florence, Italy.
Sebastian WalterDepartment of Orthopaedic Surgery, Traumatology and Reconstructive Surgery, University Hospital Cologne, Cologne, Germany.
Jorge CabrolierInstitute of Traumatology, Teodoro Gebauer, Santiago, Chile.
Marta FioccoCenter for Pediatric Oncology, Prinses Maxima Center, Utrecht, Netherlands.
Michiel A J van de SandeDepartment of Orthopaedic Surgery, Leiden University Medical Center, Leiden, Netherlands.
MORE study group

Funding

Implantcast GmbH
6 · The paper itself

Abstract

Aims: Tumour defects of the proximal humerus can be reconstructed using hemiarthroplasty, reverse shoulder arthroplasty (RSA), or anatomical total shoulder arthroplasty (TSA). This study aimed to evaluate clinical and functional outcomes of reconstructions of proximal humeral tumour defects with MUTARS endoprostheses. Methods: A total of 165 reconstructions were included: 98 (59%) hemiarthroplasties, 61 (37%) RSAs, and six (4%) TSAs. Median age was 54 years (IQR 31 to 68). Median follow-up time was 5.9 years (IQR 2.83 to 10.50). Competing risks models were employed to estimate the cumulative incidence of revision (CIR) for mechanical reasons and infection with local recurrence and mortality as competing events. The range of motion was reported using descriptive statistics. Results: Axillary nerve preservation and deltoid muscle reattachment were observed in 89% and 96% of cases, respectively, without significant differences between implant types. Rotator cuff refixation was less frequent in RSA (78%) compared to hemiarthroplasty (91%). Overall, 26 implants (16%) were revised for mechanical complications (dislocation n = 11, loosening n = 2, periprosthetic fracture n = 3) and infection (n = 10). Patients with previous surgery at the same site had a higher revision risk due to instability (cause-specific hazard ratio 3.7; 95% CI 1.3 to 10.8). The CIRs for mechanical reasons (Henderson 1 to 3) in the entire population at two, five, and ten years were 7% (95% CI 3 to 11), 11% (95% CI 6 to 17), and 13% (95% CI 7 to 20), respectively. For periprosthetic joint infection (Henderson 4), the CIRs were 5% (95% CI 2 to 10), 7% (95% CI 3 to 12), and 7% (95% CI 3 to 12). Compared with hemiarthroplasty, RSA offered superior median anteflexion (73° (IQR 40 to 90) vs 30° (IQR 5 to 45)), abduction (70° (IQR 38 to 90) vs 30° (IQR 5 to 45)), and external rotation (15° (IQR 0 to 28) vs 5° (0 to 19)). Conclusion: MUTARS proximal humerus reconstruction outcomes are satisfying, particularly in terms of mechanical failure. RSA and hemiarthroplasty exhibit comparable revision risks, with previous surgery at same site as a prognostic factor for revision due to dislocation. RSA appears to provide the best functional outcome.

Identifiers

PMID40518134
PMCPMC12167655

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.