Functionality

Between the years of 1999 and 2005, 13 patients underwent the Tikhoff-Linberg procedure with endoprosthetic replacement by Dr. Lawrence Menendez, et al., at USC. There were:

  • 5 chondrosarcomas (4 scapular and 1 proximal humeral)
  •  2 Ewing sarcomas
  •  1 pleomorphic leiomyosarcoma
  •  3 metastatic renal cell carcinomas
  •  1 metastatic uterine leiomyosarcoma
  •  1 metastatic melanoma.

Survival and Complications

Three patients have since died of recurrent or metastatic disease.

Perioperative complications included:

  • 3 dislocations (2 scapular, 1 modular humeral)
  • 2 local disturbances
  • 1 distant recurrence
  • 2 lung metastases

Other complications: 3 wound seromas, 2 poor wound healing

Post-Op Function

Affected upper extremities were immobilized for an average of 2-4 weeks. 

Physical therapy was started on average 6 weeks after surgery and continued for on average 3 months.

Good elbow, wrist, and hand function judged using MSTS criteria was noted as early as 8 weeks in some patients, with average time to good function being approximately 3 months for the entire series. Similar results were  demonstrated by other authors.19, 22, 23, 26

Recent reports show higher than average MSTS functional scores (see below) with endoprosthesis (86% vs. 62% without),  increased abduction, and better cosmetic outcomes.22, 23


Image from 28.

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