Prosthetic reconstruction after wide resection of tumors of the proximal humerus presents a unique challenge. The shoulder is a complex articulation, and patients have high expectations for postoperative function. The goal of this study is to compare functional outcomes, oncologic outcomes, and complication rates for 2 reconstructive methods. Forty patients with proximal humeral tumors were reviewed retrospectively. Proximal humeral endoprosthesis (PHE) was used for 21 patients, and reverse shoulder arthroplasty (RSA) was used for 19 patients. Clinical results, oncologic outcomes, and complication rates were assessed. The functional outcomes of the patients were assessed with the Musculoskeletal Tumor Society scoring system (MSTS), the shortened version of the Disabilities of the Arm, Shoulder and Hand (QuickDASH) score, and shoulder range of motion. The mean follow-up was 62±15 months. Shoulder dislocations occurred among 8 patients with PHE and 1 patient with RSA (P=.021). The other complication rates were similar for the 2 groups (P<.05). At the latest follow-up, the mean MSTS score was 68±10.3 for those with PHE and 76±7.7 for the patients with RSA (P=.72). However, the QuickDASH score was significantly better (P=.031) for those with RSA (mean, 19±6.3) compared with patients with PHE (mean, 30±4.8). Additionally, shoulder active abduction and forward flexion were significantly greater for the RSA group (P=.04 and P=.03, respectively). Five patients had local recurrence. Prosthetic reconstruction after oncologic resection of the proximal humerus is associated with significant limitation of shoulder range of motion and a high rate of revision surgery. However, in this study, RSA was associated with fewer dislocations, improved QuickDASH score, and greater abduction and forward flexion compared with PHE. [Orthopedics. 20XX;XX(X):xx–xx.]

广泛切除肱骨近端肿瘤后的假体重建提出了独特的挑战。肩关节是一个复杂的关节，患者对术后功能的期望值很高。本研究的目的是比较 2 种重建方法的功能结果、肿瘤学结果和并发症发生率。回顾性分析了 40 例肱骨近端肿瘤患者。21 例患者使用了近端肱骨内假体（PHE），19 例患者使用了反向肩关节置换术（RSA）。评估了临床结果、肿瘤学结果和并发症发生率。患者的功能结果使用肌肉骨骼肿瘤协会评分系统 (MSTS) 进行评估，该系统是手臂、肩部和手部残疾 (QuickDASH) 评分的简化版本，和肩部活动范围。平均随访时间为 62±15 个月。8 例 PHE 患者和 1 例 RSA 患者出现肩关节脱位（P =.021）。两组的其他并发症发生率相似 ( P <.05)。在最近的随访中，PHE 患者的平均 MSTS 评分为 68±10.3，RSA 患者的平均 MSTS 评分为 76±7.7（P =.72）。然而，与 PHE 患者（平均 30±4.8）相比，RSA 患者（平均 19±6.3）的 QuickDASH 评分明显更好 ( P =.031)。此外，RSA 组的肩部主动外展和前屈明显更大（P =.04 和P=.03，分别）。5例患者局部复发。肱骨近端肿瘤切除术后的假体重建与肩关节活动范围的显着限制和高翻修手术率相关。然而，在这项研究中，与 PHE 相比，RSA 与更少的脱位、改善的 QuickDASH 评分以及更大的外展和前屈有关。[骨科。20XX;XX(X):xx–xx.]