Long-Term Results of Hemipelvis Reconstruction With Allografts

What Are the Functional Results and Complications From Allograft Reconstruction After Partial Hemipelvectomy of the Pubis?

“…These complications must be weighed against the potential benefits that may be reported in this series. For example, we report an operative infection rate of two of 14 patients, which is within the range of what has been previously reported for other series of allograft reconstructions of the pelvis [1,3,7,10,11]. One patient developed a symptomatic inguinal incisional hernia that was discovered to be the result of a defect in the abdominal wall adjacent to the mesh that was placed at the time of his pelvic resection.…”

“…In addition, allograft or autograft pelvic ring reconstruction is traditionally thought to add complexity and risk to the procedure, including infection, nonunion, and fracture. The infection rate, for instance, in a previously published series of patients at our institution who underwent allograft reconstruction after internal hemipelvectomy for malignant pelvic bone tumors was 20% [11], although reported rates of infection with pelvic allografts have ranged from one in 13 to five in 13 [1,3,7,10]. Rates of pelvic allograft fracture have been reported ranging from zero of 16 to three of 14 with nonunion reported in one series as three of 16 [3,6,10,13,18].…”

Constrained Total Hip Megaprosthesis for Primary Periacetabular Tumors

“…hemipelvic prostheses [1,18,27,36,37], 11% to 24% in modular-type hemipelvic prostheses [11,14,24,38], and 8% to 60% in allograft reconstruction [2,22,23,26,39]. To reduce the risk of postoperative deep infection, we need to adopt intraoperative repeated and meticulous ultrasonic irrigation, routine use of antibiotic-loading bone cement, application of muscle/or musculocutaneous flap, and twostaged reconstruction after tumor resection followed by a ''Reconstruction cup'' (C-THA) endoprosthesis 55% (30%-80%) 32%…”

“…However, limb-salvage reconstruction of malignant pelvic tumors, especially in the periacetabular region, remains challenging because of the complex anatomy, the difficulty achieving wide surgical margins, and large bone and soft tissue defects after tumor resection. The reconstructive options include resection arthroplasty [7,30,33], iliofemoral or ischiofemoral arthrodesis [9,12], hip transposition method (pseudarthrosis) [3,12,32], free-vascularized fibular graft for pelvic ring reconstruction [29], allograft [2,22,23,26,39], recycled autologous bone graft [16,20], and endoprosthetic replacement [1,4,11,14,18,21,24,25,27,28,34,[36][37][38]. However, no standard reconstructive procedure exists after internal hemipelvectomy for malignant periacetabular tumors.…”

Two-staged revision with custom made prosthesis in septic failure of massive allograft reconstruction after type II-III pelvic resection

“…The main advantages of massive allograft reconstruction are restoration of the pelvic bony architecture, a durable fixation with bony union providing normal biology, and good function in concomitance with a total hip prosthesis. [1][2][3][4] However, high complication rates are associated with allograft reconstruction after pelvic resections. [4][5][6] Infection is one of the most frequent and disastrous complications.…”