Use of Ligament Advanced Reinforcement System tube in stabilization of proximal humeral endoprostheses

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.

Occupational injuries and burn out among orthopedic oncology surgeons

BACKGROUND Orthopedic oncology surgeons commonly engage in prolonged and complex surgical procedures.These types of surgeries increase the risk of physical and psychological stressors,which may in turn make these physicians prone to workrelated occupational injuries.AIM The aim of this study was to explore in orthopedic oncologists,the prevalence of work-related physical injuries and psychological disturbances.METHODS A modified version of the physical discomfort survey was developed to assess occupational injuries among orthopedic oncology surgeon members of the Musculoskeletal Tumor Society,the Canadian Orthopedic Oncology Society and European Musculoskeletal Oncology Societies.The survey was sent by email,and it explored musculoskeletal complaints,psychological disturbances,treatment required for these complaints and the requirement of time off work.RESULTS A total of 67 surgeon responses were collected.A high number of orthopedic oncologists(84%)reported an occupational injury.Low back pain(39%)was the most prevalent musculoskeletal condition,followed by lumbar disk herniation(16%),shoulder tendinitis(15%)and lateral epicondylitis(13%).Of the cohort,46%required surgery and 31%required time off work due to their injury.Thirty-three respondents reported a psychological disorder.Burnout(27%),anxiety(20%)and insomnia(20%)were the most commonly reported.Time required off work due to injury was associated with old age and years in practice.CONCLUSION Orthopedic oncology surgeons report a high prevalence of work-related disorders.Lower back related injury and burnout were the most reported disorders.Improving operative room ergonomics and prevention of stress related to the work environment should be areas to explore in upcoming research.