Pelvic reconstruction with bone cement and total hip prosthesis after resection of chondrosarcoma. Case Report

Abstract

Introduction. Chondrosarcoma is a malignant tumor of cartilaginous origin representing approximately 20-30% of all bone malignant tumors and occupying the second place in terms of their incidence. It usually affects adults between 40 and 60 years old, but can be encountered at older ages as well. Materials and methods. We report the case of a 55-year-old male patient who presented to our department with 2 weeks-long right hip pain and partial loss of functionality in right limb. We performed X-rays, magnetic resonance imaging, computed tomography, bone scintigraphy, and angiography, which established the diagnosis of pelvic tumor. Biopsy of the tumor was performed by iliofemoral approach and its result showed moderately differentiated chondrosarcoma. Orthopaedic surgery was performed, with tumoral removal within oncological limits, pelvic reconstruction using acrylic bone cement impregnated with Vancomycin and total hip arthroplasty. Results were assessed using the Musculoskeletal Tumor Rating Scale and a score of 23 out of 35 was obtained (the higher the better). Postoperative complications consisted in flap-skin necrosis that resolved within 2 months after surgery. Conclusion. Bone defects repair using antibiotic impregnated cement drastically reduced the rate of postoperative infections, thus decreasing both morbidity and mortality. In spite of technological advancement, long-term prognosis remains reserved in chondrosarcoma, due to its specific aggressivity, resistance to chemo-and radiotherapy and high rate of recurrence.

Comparative analysis of behavior of the «bone – fixator – endoprosthesis» system for I–III type internal hemipelvectomy reconstruction with and without the use of a metal bar

“…Many authors describe reliability, usability and positive feedback regarding the use of polymethyl methacrylate (bone cement) for pelvic reconstruction after tumorectomy [7][8][9].…”

“…I. Miha et al [9] described a clinical case in which they used polymethylmethacrylate, Schanz rods, total hip joint endoprosthesis, plate and screw for pelvic reconstruction after periacetabular resection. O. Е. Vyrva et al [11] used finite element method to compare the stress-strain state of the «prosthesis-humerus» system in the case of resection in the upper, middle and lower thirds of the humeral d aphysis and proofed reconstruction system.…”