ReviewAnnals of joint2025
Management of proximal humeral bone loss: a narrative review.
Review in Annals of joint, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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.
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.
Who cites it
1 citing paper in PubMed.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background and Objective: The optimal management of proximal humeral bone loss (PHBL) in shoulder arthroplasty is a debated topic. PHBL is a challenging problem for surgeons due to its effect on implant fixation and stability. Supplemental fixation options in the form of allograft-prosthetic composites (APCs) or reverse shoulder arthroplasty (RSA) endoprostheses are options to consider, each with its own benefits and complication profiles. This narrative review aims to evaluate current strategies for managing PHBL. Methods: A comprehensive literature search was performed using databases including PubMed, Cochrane Library, and Google Scholar using appropriate search terms. Studies published between 2013 and 2024 were included. All included studies were peer-reviewed and addressed PHBL in the setting of shoulder arthroplasty or proximal humerus resection. Key Content and Findings: A total of nineteen studies were included, comprising 7 retrospective case series, 4 prospective case series or cohort studies, 2 systematic reviews, 1 retrospective registry study, 3 descriptive papers of proposed classification systems, and 2 technique papers. Described classification systems categorize PHBL by integrity of the epiphysis, greater tuberosity, calcar, metaphysis, diaphysis, and cortices. Depending on the degree of bone loss, revision RSA without allograft, revision RSA with APC augmentation, and endoprosthesis are described as management options. In patients with greater than 5 cm of PHBL, use of APC or endoprosthesis has proven effective but with high complication profiles and revision rates. No paper directly compares endoprosthesis and APC outcomes. Conclusions: PHBL is a rare but important problem in the setting of tumor resection and revision shoulder arthroplasty. While small cohort studies have reported successful outcomes with both APC and endoprosthesis, systematic reviews have failed to demonstrate a clear benefit of one option over the other. Complication and reoperation rates can be high with both surgical options. With a focus on standardized classification and evaluation of patients with PHBL, we can hope to refine the surgical techniques and indications for optimal patient outcomes.
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Registered trials
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.