Reconstruction After Hemipelvectomy With the Ice-Cream Cone Prosthesis: What Are the Short-term Clinical Results?

Abstract

Background Reconstruction after internal hemipelvectomy resection likely provides better function than hindquarter amputation. However, many reconstruction methods have been used, complications with these approaches are common, and function often is poor; because of these issues, it seems important to investigate alternative implants and surgical techniques. Questions/purposes The purposes of this study were (1) to identify the frequency of surgical site complications and infection associated with the use of the Ice-Cream Cone prosthesis for reconstruction after hemipelvectomy for oncological indications; (2) to evaluate the Musculoskeletal Tumor Society (MSTS) outcomes scores in a small group of patients treated with this implant in the short term; and (3) to quantify the surgical margins and frequency of local recurrence in the short term in this group of patients. Methods Between 2008 and 2013, one center performed a total of 27 internal hemipelvectomies for oncological indications. Of those, 23 (85%) were treated with reconstruction. Our general indications for reconstruction were patients whose pelvic stability was affected by the resection and whose general condition was sufficiently strong to tolerate the reconstructive procedure. Of those patients undergoing reconstruction, 14 (61%) were treated with an Ice-Cream Cone-style implant (Coned 1 ; Stanmore Worldwide Ltd, Elstree, UK; and Socincer 1 custom-made implant for the pelvis, Gijón, Spain), whereas nine others were treated with other implants or allografts. The indications during this time for using the Ice-Cream Cone implant were pelvic tumors affecting the periacetabular area without iliac wing involvement. Of those 14, 10 were available for followup at a minimum of 2 years (median, 3 years; range, 2-5 years) unless a study endpoint (wound complication, infection, or local recurrence) was observed earlier. Study endpoints were ascertained by chart review performed by one of the authors.

Is a Modular Pedicle-hemipelvic Endoprosthesis Durable at Short Term in Patients Undergoing Enneking Type I + II Tumor Resections With or Without Sacroiliac Involvement?

“…Questions/purposes The purposes of this study were (1) to evaluate in a small case series whether the new endoprosthesis restored lower limb function and lumbopelvic stability in the short term; (2) to identify the complications associated with use of the new prosthesis; and (3) to assess the 5-year cumulative survival, the cumulative incidence of a major postoperative event, and the cumulative incidence of implant failure in this group of patients. Methods Between August 2012 and August 2014, our center performed 274 internal hemipelvectomies for oncologic indications.…”

The role of nickel-titanium shape memory alloy embracing fixator in determination of the implantation angle of hip tumor prosthesis stem following tumor resection and the analysis of its efficacy ： a retrospective study

“…Because of the tumor invasion of the proximal femur, it is often necessary to cut off the greater trochanter and lesser trochanter during the osteotomy, thus losing the anatomical markers as the reference for implanting the prosthesis stem [30]. Surgeons usually make marks on the junction before resecting the involved bone, and make marks on the corresponding part of the prosthesis stem to offer reference when implanting the prosthesis stem [31,32]. After implanting the prosthesis stem, it will be…”

Complications and Cost Analysis of Hemipelvectomy for the Treatment of Pelvic Tumors

“… 2 , 3 , 13 , 14 Gebert et al 11 reported good results with a low infection rate of 3 in 17 patients subjected to medialization of the hip with femoral endoprosthesis implantation. Barrientos-Ruiz 15 had 10 wound and 2 deep infections in ten ice-cream-cone prosthesis implantations. Zeifang et al 5 suggested that biological reconstruction should be performed in younger patients, providing better longstanding functional results, whereas in older patients, endoprosthetic reconstruction should be preferred because of lower complication rates.…”