The proximal humerus is a common location for malignant lesions of the bone. With the advent of limb-sparing approaches, several reconstructive options have been developed. Although allograft reconstructions are technically difficult and fraught with potential complications, they may provide a better functional outcome. One major drawback to using allografts is the articular degeneration that almost universally occurs. One recently developed method for avoiding this problem is the use of endoprosthesis-allograft composites. This article will relate the specific indications and the appropriate preoperative assessment for performing allograft or endoprosthesis-allograft reconstructions for malignant lesions of the proximal humerus. The focus will be on the specifics of the operative technique and the critically important postoperative rehabilitation. Finally, the limited results that have been reported on this topic to date will be discussed.
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