Endoprosthetic Total Scapula Replacement Versus Suspension Arthroplasty Following Tumor Resection

The purpose of this study is to define the minimum requirements for total scapular replacement with metallic endoprosthesis and compare it to suspension arthroplasty. A retrospective analysis was performed of three musculoskeletal tumor registries for patients with scapulectomy for musculoskeletal tumors. Patients were divided into two groups: Group I included eleven patients who had endoprosthetic scapula replacement (Endotec, Bloomfield, NJ, Howmedica, Rutherford, NJ). Group II included nine patients with suspension arthroplasty. Overall MSTS scores were higher in group I than in Group II (23.5+2.5 versus 17+2.6; p=0.0001). Scores in Group I was significantly higher in all categories but dexterity. The lowest score in both groups was in the function category (3.6+0.8 versus 1.7+1.0; p<0.001). The data shows that patients with endoprosthetic replacements have higher MSTS scores in emotional acceptance and function, compared to those with suspension arthroplasty. The greater motion found in group I (endo) was most evident in forward flexion, abduction and external rotation. This was thought to be a results of lateral positioning, scapulothoracic reconstruction and pseudoarthrosis.