{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T11:04:15Z","timestamp":1790075055020,"version":"4.0.1"},"reference-count":25,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T00:00:00Z","timestamp":1789603200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Curr. Oncol.","Current Oncology"],"abstract":"<jats:p>Background\/Objectives: Total scapulectomy for malignant scapular tumors remains a major reconstructive challenge because resection removes the osseous framework, muscular insertions, and biomechanical support required for shoulder function. Patient-specific three-dimensional (3D)-printed implants may improve anatomical reconstruction, but the indications and surgical principles underlying successful total scapular replacement remain poorly defined. Methods: This retrospective single-center case series included the first three consecutive patients who underwent total scapulectomy followed by immediate reconstruction using a patient-specific 3D-printed scapular prosthesis between January 2024 and December 2025. Clinical, radiographic, oncological, and functional outcomes were reviewed. Functional outcome was assessed using the Musculoskeletal Tumor Society (MSTS) score and active shoulder range of motion. Results: The cohort included two women and one man with a median age of 53 years (range, 43\u201358 years). Diagnoses were chondrosarcoma in two patients and osteosarcoma in one. All tumors were Enneking stage IIB. Negative margins were achieved in all patients, and the axillary nerve and principal shoulder-girdle stabilizers were preserved in every case. Median follow-up was 13 months (range, 12\u201327 months). At latest follow-up, two patients had no evidence of disease and one was alive with disease after developing pulmonary metastases. The median MSTS score was 25\/30 (range, 21\u201326). Median active elbow flexion, abduction, and forward flexion measured 88\u00b0, 80\u00b0, and 80\u00b0, respectively. Two patients experienced complications: one clavicular fracture and one aseptic wound dehiscence; neither resulted in implant failure or required revision of the reconstruction. Conclusions: Patient-specific total scapular reconstruction may provide satisfactory early radiographic and functional outcomes in carefully selected patients, although outcomes remain variable depending on individual patient and tumor characteristics. Implant design, patient selection, preservation of the axillary nerve and viable innervated shoulder-girdle musculature, and soft-tissue reconstruction should be considered complementary components of this reconstructive strategy.<\/jats:p>","DOI":"10.3390\/curroncol33090565","type":"journal-article","created":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T09:04:17Z","timestamp":1790067857000},"page":"565","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Beyond Implant Design: Surgical Principles and Early Outcomes of Patient-Specific Scapular Reconstruction After Total Scapulectomy"],"prefix":"10.3390","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2089-4876","authenticated-orcid":false,"given":"Adyb-Adrian","family":"Khal","sequence":"first","affiliation":[{"name":"Faculty of Medicine and Pharmacy, University of Oradea, 410087 Oradea, Romania"},{"name":"Department of Orthopaedics, Pelican Medicover Hospital, 410450 Oradea, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruxandra Florina","family":"Bodog","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Pharmacy, University of Oradea, 410087 Oradea, Romania"},{"name":"Department of Plastic Surgery, Pelican Medicover Hospital, 410450 Oradea, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8332-7708","authenticated-orcid":false,"given":"Florian Dorel","family":"Bodog","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Pharmacy, University of Oradea, 410087 Oradea, Romania"},{"name":"Department of Plastic Surgery, Pelican Medicover Hospital, 410450 Oradea, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ovidiu-Gogu","family":"Cacuci","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Pharmacy, University of Oradea, 410087 Oradea, Romania"},{"name":"Department of Orthopaedics, Pelican Medicover Hospital, 410450 Oradea, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1016\/S0030-5898(20)31629-1","article-title":"Tumors of the Shoulder Girdle: Technique of Resection and Description of a Surgical Classification","volume":"22","author":"Malawer","year":"1991","journal-title":"Orthop. Clin. N. Am."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"568","DOI":"10.1007\/s10147-011-0229-z","article-title":"Functional Outcomes after Total Scapulectomy for Malignant Bone or Soft Tissue Tumors in the Shoulder Girdle","volume":"16","author":"Hayashi","year":"2011","journal-title":"Int. J. Clin. Oncol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"869","DOI":"10.1007\/s00264-009-0857-3","article-title":"Limb Sparing Surgery for Bone Tumours of the Shoulder Girdle: The Oncological and Functional Results","volume":"34","author":"Yang","year":"2009","journal-title":"Int. Orthop."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"684","DOI":"10.1302\/0301-620X.96B5.32241","article-title":"Interscapulothoracic Resection of Tumours of Shoulder with a Note on Reconstruction","volume":"96","author":"Xie","year":"2014","journal-title":"Bone Jt. J."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1016\/j.jbo.2016.10.003","article-title":"Experience of Total Scapular Excision for Musculoskeletal Tumor and Reconstruction in Eastern Asian Countries","volume":"9","author":"Hayashi","year":"2017","journal-title":"J. Bone Oncol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"2309499019838355","DOI":"10.1177\/2309499019838355","article-title":"Malignant Tumors of the Shoulder Girdle: Surgical and Functional Outcomes","volume":"27","year":"2019","journal-title":"J. Orthop. Surg."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1111\/os.12248","article-title":"Functional Results and Emotional Acceptance after Scapulectomy for Malignant Shoulder Tumors","volume":"8","author":"Xu","year":"2016","journal-title":"Orthop. Surg."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Yu, X.J., Liu, Q.K., Wang, Y.G., Wang, S.X., Lu, R., Xu, H.R., Wan, J.L., and Kang, H. (2022). Oncologic and Functional Outcomes of Different Reconstruction Modalities after Resection of Chondrosarcoma of the Scapula: A Medium- to Long-Term Follow-up Study. BMC Musculoskelet. Disord., 23.","DOI":"10.1186\/s12891-022-05661-7"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1016\/j.jor.2024.02.019","article-title":"Is Polypropylene Mesh Reconstruction Functionally Superior to Non Reconstructive Group Following Total Scapular Resection? A Retrospective Analysis of 16 Patients and a Systematic Review of the Literature","volume":"52","author":"Salunke","year":"2024","journal-title":"J. Orthop."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"e28","DOI":"10.1016\/j.jse.2008.07.014","article-title":"Extracorporeally Irradiated Scapula as Autograft in Tumor Surgery","volume":"18","author":"Chandrasekar","year":"2009","journal-title":"J. Shoulder Elb. Surg."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1186\/s12957-019-1636-2","article-title":"Shoulder Girdle Resection: Surgical Technique Modification and Introduction of a New Classification System","volume":"17","author":"Shehadeh","year":"2019","journal-title":"World J. Surg. Oncol."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Beltrami, G., Ristori, G., Scoccianti, G., Tamburini, A., Capanna, R., Campanacci, D., and Innocenti, M. (2018). Latissimus Dorsi Rotational Flap Combined with a Custom-Made Scapular Prosthesis after Oncological Surgical Resection: A Report of Two Patients. BMC Cancer, 18.","DOI":"10.1186\/s12885-018-4883-7"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"e888","DOI":"10.3928\/01477447-20181023-05","article-title":"Total Scapulectomy and Shoulder Reconstruction Using a Scapular Prosthesis and Constrained Reverse Shoulder Arthroplasty","volume":"41","author":"Savvidou","year":"2018","journal-title":"Orthopedics"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1080\/08998280.2024.2351313","article-title":"Clinical and Functional Results after Total Scapulectomy in Orthopedic Oncology: Are Custom-Made Scapular Prostheses Better than Humeral Suspension?","volume":"37","author":"Ipponi","year":"2024","journal-title":"Bayl. Univ. Med. Cent. Proc."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1557","DOI":"10.1007\/s00590-024-03839-4","article-title":"3D-Printed Glenoid Implant Reconstruction, after Partial Scapulectomy for Malignant Tumors: A Case Series","volume":"34","author":"Trikoupis","year":"2024","journal-title":"Eur. J. Orthop. Surg. Traumatol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"829","DOI":"10.1007\/s00264-020-04523-y","article-title":"Analysis of Principles Inspiring Design of Three-Dimensional-Printed Custom-Made Prostheses in Two Referral Centres","volume":"44","author":"Angelini","year":"2020","journal-title":"Int. Orthop."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"611","DOI":"10.1002\/jso.21340","article-title":"Total Scapulectomy and Constrained Reverse Total Shoulder Reconstruction for a Ewing\u2019s Sarcoma","volume":"100","author":"Mavrogenis","year":"2009","journal-title":"J. Surg. Oncol."},{"key":"ref_18","first-page":"1968621","article-title":"Reconstruction with Total Scapular Reverse Total Shoulder Endoprosthesis after Radical Tumor Excision","volume":"2021","author":"Harvey","year":"2021","journal-title":"Case Rep. Oncol. Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"e24-00397","DOI":"10.2106\/JBJS.CC.24.00397","article-title":"Novel 3D-Printed Reverse Shoulder Prosthesis for Reconstruction After Resection of the Scapular: A Report of 2 Cases","volume":"15","author":"Li","year":"2025","journal-title":"JBJS Case Connect."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Fulchignoni, C., Pietramala, S., Lopez, I., Mazzella, G.G., Comisi, C., Perisano, C., Rocchi, L., and Greco, T. (2024). Surgical Outcomes and Complications of Custom-Made Prostheses in Upper Limb Oncological Reconstruction: A Systematic Review. J. Funct. Morphol. Kinesiol., 9.","DOI":"10.3390\/jfmk9020072"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"S153","DOI":"10.1016\/j.otsr.2018.04.024","article-title":"Reconstruction Techniques after Proximal Humerus Tumour Resection","volume":"105","author":"Sirveaux","year":"2019","journal-title":"Orthop. Traumatol. Surg. Res."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"2245","DOI":"10.1007\/s11999-014-3474-4","article-title":"Outcome after Reconstruction of the Proximal Humerus for Tumor Resection: A Systematic Review","volume":"472","author":"Teunis","year":"2014","journal-title":"Clin. Orthop. Relat. Res."},{"key":"ref_23","first-page":"94","article-title":"3D Printing Metal Implants in Orthopedic Surgery: Methods, Applications and Future Prospects","volume":"42","author":"Meng","year":"2023","journal-title":"J. Orthop. Transl."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1016\/j.jse.2015.06.021","article-title":"Allograft-Prosthetic Composite Reverse Total Shoulder Arthroplasty for Reconstruction of Proximal Humerus Tumor Resections","volume":"25","author":"King","year":"2016","journal-title":"J. Shoulder Elb. Surg."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"102957","DOI":"10.1016\/j.otsr.2021.102957","article-title":"Reconstruction by Allograft-Prosthetic Composite Reverse Shoulder Arthroplasty after Proximal Humerus Tumor Resection: Clinical and Radiographic Assessment at a Minimum 2 Years\u2019 Follow-Up","volume":"108","author":"Callamand","year":"2022","journal-title":"Orthop. Traumatol. Surg. 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