| الملخص: | Introduction Currently the organ-preserving surgical treatment (oncological arthroplasty) may be provided in 90% of patients with malignant lesions of the long bones and large joints. Due to the development and improvement of surgical techniques, the application of new antibacterial drugs, the development of new systems of modular endoprosthesis managed to achieve a meaningful reduction of complications, such as infection, instability of the endoprosthesis, and receive good and excellent functional results after surgery, mainly in lesions of the bones of the lower extremities. The risk of complications in conducting oncoloicaly arthroplasty upper extremity is also low, but functional performance after these operations is significantly lower. Objective.To analyze and evaluate the results of applying the "Anatomical" and "Reverse" shoulder replacements in patients with neoplastic lesions of the proximal humerus.Materials and methods. Depending on the type of metal implants patients were divided into two groups. "Anatomical" implant was installed in 28 patients (13 men and 15 women) and "Reverse" prosthesis in 14 patients (6 men and 8 women). The average age was in the first group 32±4 years and the second 38±3 years, respectively. Primary bone tumors were diagnosed in 19 (68%) patients first and 12 (86%) patients of the second group.Results. The average follow-up period was 42 months. 4 patients with primary malignant bone tumors had the progression of the disease during the period from 6 to 14 months. In 2 of them they diagnosed the metastatic lung disease, in one case – the recurrence of tumor and also in one patient there was the relapse with metastases to the lungs. In the group of patients with "Anatomical" arthroplasty of the shoulder joint functional status after surgery was assessed according to the scale MSTS (Musculo-skeletal tumor standing System) in the range of 60-80 points - 3, 40-60 points - 6 and less than 40 points in 19 patients, respectively. Patients who selected "Reverse" prosthesis of functional status on a scale MSTS were in the range of from 80 to 100 points in 6 patients , 60-80 points - 6, 40-60 points - 2 patients, respectively. They marked the improvement in functional status with Reverse arthroplasty in 75% of cases.Conclusion. The use of modular "Return" implants in organ-preserving treatment of patients with neoplastic lesions of the proximal humerus, compared to the "Anatomical" arthroplasty, is a more promising technique, because it allows significantly improved functional outcome and social adaptation after surgery.
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