NCT07471022

Hemiarthroplasty for Elderly With Proximal Humeral Mets

The Application of Hemiarthroplasty in Elderly Patients With Proximal Humeral Metastases

• Status: Completed
• Phase: —
• Study type: Observational
• Enrollment: 53 (actual)
• Sponsor: Sichuan Provincial People's Hospital · Academic / Other
• Sex: All
• Age: —
• Healthy volunteers: Not accepted

Summary

Bone metastases are common in patients with advanced cancer and frequently involve the proximal humerus, leading to severe pain and loss of shoulder function. Shoulder arthroplasty is an important surgical option for restoring limb function and relieving pain in these patients. However, elderly patients often have multiple comorbidities, and it remains unclear whether age affects surgical outcomes and prognosis after arthroplasty for proximal humeral metastases. This retrospective observational study reviewed patients with isolated proximal humeral metastases who underwent shoulder arthroplasty at our institution. Patients were divided into elderly and younger groups based on age, and clinical outcomes were compared between the groups. Evaluated outcomes included operative characteristics, postoperative pain, limb function, complications, survival, recurrence, and quality of life. The aim of this study is to determine whether age influences prognosis and functional recovery after shoulder arthroplasty for proximal humeral metastases, and to assess the feasibility and effectiveness of this surgical procedure in elderly patients.

Detailed description

This retrospective observational study reviewed patients who underwent proximal humeral hemiarthroplasty (PHH) for solitary metastatic lesions of the proximal humerus at our institution between 2013 and 2021. A total of 53 patients with histopathologically confirmed metastatic bone tumors were included in the analysis. The study population consisted of 25 males and 28 females, with ages ranging from 43 to 82 years. Patients were divided into two groups according to age: Group A (≥65 years, n = 25) and Group B (\<65 years, n = 28). All metastatic lesions were unilateral and located in the proximal one-third of the humerus without involvement of the scapula. The most common primary malignancies included breast cancer, lung cancer, renal cell carcinoma, thyroid cancer, prostate cancer, colorectal cancer, hepatocellular carcinoma, gastric cancer, uterine cancer, and cancer of unknown primary origin. Prior resection of the primary tumor had been performed in 22 patients before presentation. Nineteen patients had comorbidities such as diabetes mellitus, hypertension, chronic gastritis, or pulmonary emphysema. Pathological fractures were present in 19 cases. All patients underwent wide tumor excision followed by proximal humeral hemiarthroplasty using a Malawer type I resection technique. Clinical and surgical data were collected from medical records for subsequent analysis.

Conditions

• Bone Metastases of a Malignant Tumor
• Metastatic Bone Tumor

Interventions

Type	Name	Description
PROCEDURE	Proximal Humeral Hemiarthroplasty	Patients underwent wide tumor excision followed by proximal humeral hemiarthroplasty. En bloc resection was performed according to tumor-free principles, with preservation of the axillary nerve and deltoid muscle whenever possible. Osteotomy was performed 2-3 cm distal to the tumor margin. A tumor-specific prosthesis was implanted and soft tissues were reconstructed. A Ligament Advanced Reinforcement System (LARS) was used when necessary to improve joint stability.

Timeline

• Start date: 2013-01-01
• Primary completion: 2021-12-31
• Completion: 2025-09-04
• First posted: 2026-03-13
• Last updated: 2026-03-13