Page 58 - Reconstructive Techniques in Musculoskeletal Tumor Surgery

Chapter 3
We have used the titanium pedestal cup prosthesis (Zimmer, Freiburg, Germany) to reconstruct type 2 and type 2/3 defects of the pelvis. The prosthesis was originally designed for use after the extensive revision of a total hip replacement ( gure 1). To the best of our knowledge, we are the rst to describe its use in a consecutive series of patients with a pelvic malignancy. In this two-center retrospective study, our aims were to evaluate the mid- to long-term survival of the implant, its complications and the patient’s resulting functional outcome and quality of life.
Figure 1: Photograph showing the pedestal cup prosthesis.
Patients and Methods
After obtaining institutional ethics board approval, we assessed all consecutive patients in whom a pedestal cup had been used to reconstruct the defect created by a type 2 or type 2/32 internal hemipelvectomy for pelvic malignancy between 2003 and 2009.
There were 19 patients (11 male, 8 female) with a mean age of 48 years (14 to 72) at the time of surgery. The principal diagnosis was chondrosarcoma in 13, Ewing’s sarcoma in three and metastatic carcinoma in three. All lesions involved the acetabulum and were Enneking stage 2B20. A total of four patients had undergone previous surgery, including three total hip replacements and one allograft-prosthetic reconstruction which failed due to resorption of the allograft.
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