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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
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.