Retrospective Study
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Apr 18, 2016; 7(4): 265-271
Published online Apr 18, 2016. doi: 10.5312/wjo.v7.i4.265
Use of Ligament Advanced Reinforcement System tube in stabilization of proximal humeral endoprostheses
Nikolaos A Stavropoulos, Hassan Sawan, Firas Dandachli, Robert E Turcotte
Nikolaos A Stavropoulos, Firas Dandachli, Robert E Turcotte, Department of Orthopedic Surgery, McGill University Health Centre, Montreal, QC H3G 1A4, Canada
Hassan Sawan, King Fahad Medical City, Riyadh 13521-7751, Saudi Arabia
Author contributions: Stavropoulos NA and Turcotte RE designed the study; Stavropoulos NA, Sawan H and Turcotte RE analysed the literature; Stavropoulos NA, Sawan H and Dandachli F acquired and analyzed the data; Turcotte RE supervised the project and critically reviewed the draft; all authors approved the final submitted version of the manuscript.
Institutional review board statement: We are pleased to inform you that request has been found ethically acceptable and we hereby grant you approval, via expedited review by the Chairman on August 9, 2013, to conduct the aforementioned study at the McGill University Health Centre.
Informed consent statement: As per our regulations no informed consent is required to perform a retrospective review analysis of medical records and X-rays. Personal informations were kept confidential.
Conflict-of-interest statement: All authors declare that they have no conflict of interest. No benefits of any source were received for the production of this work.
Data sharing statement: As per our regulations no data sharing statement is required to perform a retrospective review analysis of medical records and X-rays. Personal informations were kept confidential.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Correspondence to: Robert E Turcotte, MD, FRCS(c), Chairman of the Department of Orthopaedic Surgery, McGill University Health Centre, 1650 Cedars Ave #B5 159.6, Montreal, QC H3G 1A4, Canada.
Telephone: +1-514-9341934-42266 Fax: +1-514-9348453
Received: October 18, 2015
Peer-review started: October 20, 2015
First decision: December 7, 2015
Revised: January 11, 2016
Accepted: January 27, 2016
Article in press: January 29, 2016
Published online: April 18, 2016

AIM: To review outcomes following usage of the Ligament Advanced Reinforcement System (LARS®) in shoulder tumors.

METHODS: Medical records of nineteen patients (19 shoulders) that underwent tumor excisional procedure and reconstruction with the LARS synthetic fabric, were retrospectively reviewed.

RESULTS: Patients’ median age was 58 years old, while the median length of resection was 110 mm (range 60-210 mm). Compared to immediate post-operative radiographs, the prosthesis mean end-point position migrated superiorly at a mean follow up period of 26 mo (P = 0.002). No statistical significant correlations between the prosthesis head size (P = 0.87); the implant stem body length (P = 0.949); and the length of resection (P = 0.125) with the position of the head, were found at last follow up. Two cases of radiological dislocation were noted but only one was clinically symptomatic. A minor superficial wound dehiscence, healed without surgery, occurred. There was no evidence of aseptic loosening either, and no prosthetic failure.

CONCLUSION: LARS® use ensured stability of the shoulder following endoprosthetic reconstruction in most patients.

Keywords: Proximal humeral endoprostheses, Ligament Advanced Reinforcement System

Core tip: Endoprosthetic replacement of the proximal humerus for tumor resection offers predictable outcome. In an attempt to optimize functional scores, the use of Ligament Advanced Reinforcement System (LARS) tubes was facilitated. Our retrospective analysis revealed that LARS was not associated with specific complications. Its ability to ensure shoulder stability was good, albeit not perfect. Superior migration of the humeral head was common over time.