Page 56 - Reconstructive Techniques in Musculoskeletal Tumor Surgery

Chapter 3
Abstract
Periacetabular tumor resections and their subsequent reconstruction are among the most challenging procedures in orthopaedic oncology. Despite the fact that a number of di erent pelvic endoprostheses have been introduced, rates of complication remain high and long-term results are mostly lacking.
In this retrospective study, we aimed to evaluate the outcome of reconstructing a periacetabular defect with a pedestal cup endoprosthesis after a type 2 or type 2/3 internal hemipelvectomy.
A total of 19 patients (11 male, 8 female) with a mean age of 48 years (14 to 72) were included, most of whom had been treated for a primary bone tumor (n = 16) between 2003 and 2009. After a mean follow-up of 39 months (28 days to 8.7 years), seven patients had died. After a mean follow-up of 7.9 years (4.3 to 10.5), 12 patients were alive, of whom 11 were disease-free. Complications occurred in 15 patients. Three had recurrent dislocations and three experienced aseptic loosening. There were no mechanical failures. Infection occurred in nine patients, six of whom required removal of the prosthesis. Two patients underwent hindquarter amputation for local recurrence.
The implant survival rate at ve years was 50% for all reasons, and 61% for non- oncological reasons. The mean Musculoskeletal Tumor Society score at nal follow-up was 49% (13% to 87%).
Based on these poor results, we advise caution if using the pedestal cup for reconstruction of a periacetabular tumor resection.
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