Periacetabular Limb Salvage for Malignant Bone Tumours

Abstract

Malignant periacetabular tumours are difficult to manage. Functional results of our patients with no reconstruction or with bone-graft bridging were fair. Patients undergoing internal hemipelvectomy may experience leg-length discrepancies, which can be balanced with shoe lifts.

Internal Hemipelvectomy for Pelvic Sarcomas Using a T-incision Surgical Approach

“…Although postoperative complications were common in our series (43%), most were minor and healed well with antibiotics and one I & D. Our major complications were not life-threatening and most required only I & D. Other studies report postoperative complication rates of 31% to 60% [3,8,28] for internal hemipelvectomy, with the highest incidences being infection (7%-50%) [1,4,8,10,22] and wound healing problems (13%-29%) [1,4,8,10,28]. Our infection rate was 20% and our wound complication rate also was 20%.…”

“…Of the two patients with positive margins, one had local recurrence treated with amputation and was disease-free at last followup; the second patient died of combined local and metastatic disease spread at 11 months. Comparable rates of local recurrence (15%-36%) [1,3,8,10,12] and death (23%-33% at 2 years and 28%-49% at 5 years) [1,3,12] are reported in other studies of internal hemipelvectomy for pelvic sarcomas, reflecting the inherently aggressive behavior of these tumors. It has been suggested recurrence and mortality in these patients are more closely related to presurgical disease state than to the type or extent of resection [6,21].…”

“…Flail hips allow for reasonable function without incurring the additional risks of hardware failure that can occur with reconstructed hips in general, regardless of the type of surgical approach used. Leg-length discrepancy [3,9] and substantially reduced hip motion should be expected [13,18], but they do not preclude the ability to walk, drive, and return to work for most patients [9,27]. Shoe lifts can be used to compensate for leg-length discrepancies [3] and may help avoid consequences of abnormal gait, such as back pain or stress on the contralateral leg.…”

Types of extended organ-sparing and reconstructive surgical interventions for tumor involvement of the cotyloid cavity

“…А. Asavamongkolkul и соавт. [23] сообщают о 13 пациентах с первичными зло-качественными опухолями параацетабулярной области, которым была выполнена межподвздошно-брюшная ре-зекция. Радикальные операции с индексом R0 были вы-полнены у 9 (70%) пациентов.…”

Internal Hemipelvectomy for Musculoskeletal Tumors—Indications and Options for Reconstruction

“…[6][7][8][9][10][11] As a result, most authors currently advocate replacement of the resected bone using a prosthetic device or allograft, or by using other means to reconstruct the pelvic ring. 6,[12][13][14][15][16][17] Options for reconstruction include allograft,allograft-prosthetic composite, and endoprosthetic reconstruction.…”