Functional Outcome Following Reconstruction with the
Thai Modular Proximal Humeral Endoprosthesis
Piya Kiatisevi MD*, Bhasanan Sukunthanak MD*, Pongsiri Piakong MD*, Dumnoensun Pruksakorn MD, PhD**,
Taninnit Leerapun MD, MS**, Chris Charoenlap MD***, Kavin Karunratanakul PhD****,
Marut Wongcumchang MEng****, Kriskrai Sitthiseripratip PhD****
Affiliation :
* Orthopaedic Oncology Unit, Institute of Orthopaedics, Lerdsin General Hospital, Bangkok, Thailand
** Department of Orthopedics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
*** Department of Orthopaedics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
**** National Metal and Material Technology (MTEC), Pathum Thani, Thailand
Background : Proximal humeral replacement with endoprosthesis is a well-accepted procedure for treatment of malignant
or aggressive bone tumors. In Thailand, the Thai modular proximal humeral (TMPH) endoprosthesis has been manufactured
and little is known about the results following its implantation.
Objective : To report the short-term functional and oncologic outcomes following implantation of the TMPH endoprosthesis
system and its complications.
Material and Method: We prospectively reviewed 10 consecutive patients treated with wide proximal humeral resection
and implantation with the TMPH endoprosthesis in our three centers: six patients from Lerdsin General Hospital, three patients
from Maharaj Nakorn Chiang Mai Hospital, and one patient from King Chulalongkorn Memorial Hospital. The mean age
was 52 years old, range (17 to 78). The mean resection length was 13 cm, range (9 to 17). The mean follow-up time was
9.7 months, range (0.6 to 19.5); the mean follow-up time for surviving patients was 14.5 months, range (8.7 to 19.5). The
musculoskeletal tumor society (MSTS) score, radiographs, and complications were recorded.
Results : Three patients died of disease at 2.6 months, range (2.1 to 4.1) and one patient died of his underlying disease at
0.6 months after the surgery. There were no infection, proximal migration, recurrence, or implant-related complication.
The mean MSTS score was 21, range (18 to 25). The mean active shoulder abduction was 42°, range (20° to 80°) and flexion
was 45°, range (25° to 85°). The mean passive shoulder abduction was 104°, range (45° to 170°) and flexion was 102°,
range (45° to 170.5°).
Conclusion : Although longer follow-up is required, our satisfactory result showed that reconstruction using the TMPH
endoprosthesis is a practicable option with good functional result and low complication rate.
Keywords : Proximal humerus, Endoprosthesis, Outcome, Complications
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