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Chapter 1
Figure 7: Drawings of the surgical procedure of reconstructing an acetabular defect with the “Ring prosthesis”. First, a cannulated drill prepares the track for the prosthesis. Next, the cup is countersunk by using a conical reamer, and the implant is inserted (from P.A. Ring, Complete replacement arthroplasty of the hip by the ring prosthesis [Journal of Bone & Joint Surgery, British Volume: volume 50 – Issue 4, 720-731]).
The pedestal cup endoprosthesis (Schoellner cup; Zimmer, Freiburg, Germany) is one of the implant designs that follow this principle. In chapter 3, we evaluate clinical outcome of periacetabular reconstruction with the pedestal cup endoprosthesis in treatment of periacetabular tumors. Experiences with this implant in both revision hip arthroplasty and orthopaedic oncology had previously been described64-66. We were the rst to report on its use in a consecutive series of patients with a pelvic malignancy41.
Based on experiences with the pedestal cup endoprosthesis, the LUMiC prosthesis (implantcast GmbH, Buxtehude, Germany) was designed. Chapter 4 evaluates the short-term clinical results of periacetabular reconstruction with this novel device, and describes results from a retrospective multicenter study52.
Part II: Management of Extremity Bone Tumors
In the history of orthopaedic surgery, there has always been a strong desire for successful reconstruction of diseased, deformed, or disabled limbs. This dream was presumably rst described in the“Miracle of the Black Leg”, in the third century AD67. In this folktale, the Saints Cosmas and Damian successfully amputated a cancerous lower limb of a church retainer, and replaced it with the leg of a Moor who had died that morning ( gure 8). Over the centuries that followed, many authors reported on their attempts to successfully reconstruct a diseased (segment of) bone with an allograft – a transplant from a genetically non-identical donor of the same species. The rst successful bone allograft transplantation is generally ascribed to Macewen, who reconstructed part of the humerus in a 3-year-old boy who had osteomyelitis with bone segments obtained from a rachitic patient68.
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