# Functional and Rehabilitative Outcomes of Patients Affected by Bone Cancer of the Upper Limb Treated with MUTARS Prosthesis: A Narrative Review

## TL;DR

This review examines how well patients with upper limb bone cancer recover after surgery using MUTARS prostheses and highlights the need for better rehabilitation protocols.

## Contribution

The paper provides a narrative review of functional and rehabilitative outcomes after MUTARS prosthetic surgery for upper limb bone cancer, emphasizing gaps in current literature.

## Key findings

- MUTARS prostheses are effective for reconstructing the proximal humerus after tumor resection.
- Rehabilitation is crucial but lacks standardized protocols in current clinical practice.
- Most studies focus on metastatic proximal humerus tumors treated with modular implants.

## Abstract

Megaprostheses are well-known, reliable, and effective reconstruction prostheses used in oncologic surgery for limb salvage in patients affected by primary or metastatic bone tumors. Rehabilitation plays a major role after MUTARS replacement, with the aim of improving function after surgery and maintaining the highest possible quality of life. Only a few studies have been published about the use of megaprostheses for the upper limb. The aim of this narrative review is to describe the results of functional and rehabilitative outcomes of patients affected by bone primary or metastatic bone cancer of the upper limb and surgically treated with MUTARS prostheses. A comprehensive search was conducted on PubMed and Scopus using the following MESH terms: “Mutars”, “Megaprosthesis”, “bone”, “tumors”, “metastasis”, “upper limb”, “rehabilitation”, “outcome”, “quality of life”, and 10 studies were included. The most frequent oncological pathology was found to be metastases of the proximal humerus treated with modular endoprosthesis or modular reverse implants. Outcome measures used were ROM, MSTS, ASES, DASH, Constant-Murley score, Enneking score, VAS, MEP, TESS, and WOSI. Reconstruction of the proximal humerus with the MUTARS system seemed to be a valid treatment option after bone tumor resection. Rehabilitation after MUTARS surgery is very relevant, but currently, functional and rehabilitative outcomes are inadequately represented in the literature. Hence, further studies are needed to define standardized rehabilitation protocols after oncological orthopedic surgery that can be applied routinely in clinical practice.