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

Karim, Syed M.; Colman, Matthew W.; Lozano-Calderón, Santiago; Raskin, Kevin A.; Schwab, Joseph H.; Hornicek, Francis J.

doi:10.1007/s11999-014-4009-8

Cited by 21 publications

(19 citation statements)

References 17 publications

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“…For the treatment of bone defects after type III hemipelvectomy, more and more surgeons tend to reconstruct defect because of the reported complications. Up to now, allograft, mesh repair and arti cial ligament repair are the main choices for reconstruction after type III hemipelvectomy (11,12,16). Recent reconstruction ways after type III resection were listed in Table 3.…”

Section: Discussionmentioning

confidence: 99%

“…Currently, some reconstruction methods have been reported after type III hemipelvectomy, including allograft, mesh and arti cial ligament (11,12). However, large amount of studies revealed various limitations of these reconstruction options.…”

Section: Introductionmentioning

confidence: 99%

“…Although allograft could provide a bony reconstruction, high operative infection rate was frequently reported by some researches (2). Researches showed that the infection rate of allograft after type III hemipelvectomy is as high as 20% (12,13). Soft tissue reconstruction like mesh and arti cial ligament is easy and convenient, but the mechanical stability of the pelvis is ignored which results in changes of pelvic structure and mechanics causing complications like acetabular shift and sacroiliitis.…”

Section: Introductionmentioning

confidence: 99%

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Three-dimensional-printed customized prosthesis for pubic defect: Clinical outcomes in 5 cases at a mean follow-up of 17 months

et al. 2020

Preprint

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Background This study is to present and evaluate the short-term clinical outcomes and associated complications of 3D-printed customized prostheses for pubic defect reconstruction. Methods 5 patients receiving type III hemipelvectomy and three-dimensional-printed customized prosthesis reconstruction at our institution between 2017 and 2019 were retrospectively analyzed in this study. The operation time and blood loss during operation were recorded. The local and functional recovery was assessed by the physical examination and Musculoskeletal Tumor Society (MSTS) score. The prosthetic position and Osseointegration were evaluated by imaging examination. Oncology result and complications were recorded. Functional comparisons with MSTS score of patients grouped by resection extent were done. Results Of 5 cases, the prosthese consist of the type with stem (3, 60%) and the type without stem (2, 40%). Mean follow-up period was 17.6 months (range, 10–26 months). All 5 patients were alive with no evidence of disease. No deep infection and local recurrence occurred. The mean blood loss and mean intraoperative time was 1680 ml (range, 300 to 3700 ml) and 294 min (range, 180 to 430 min). The mean functional MSTS score at the final follow-up was 29.8 (range, 29–31). 1 male patient complained erectile dysfunction. Fretting wear around prosthetic stem was found in 3 patients while bone wear on the normal side pubis was found in 2 patients. Osseointegration was observed in all patients. Conclusion 3D-printed customized prostheses could be a feasible option to reconstruct the pubic bone defects after type III hemipelvectomy. The good outcomes are inseparable from precision prostheses design and strict surgical procedures.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Three-dimensional-printed customized prosthesis for pubic defect: Clinical outcomes in 5 cases at a mean follow-up of 17 months

et al. 2020

Preprint

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“…At present, allograft, mesh, and artificial ligament are the most common reconstruction methods after type III resection [11,12]. Although allograft could provide a bony reconstruction, high operative infection rate was frequently reported by some researches [2].…”

Section: Introductionmentioning

confidence: 99%

“…Although allograft could provide a bony reconstruction, high operative infection rate was frequently reported by some researches [2]. Researches showed that the infection rate of allograft after type III internal hemipelvectomy is as high as 20% [11,13]. Soft tissue reconstruction like mesh and the artificial ligament is easy and convenient, but the mechanical stability of the pelvis is ignored which results in changes of pelvic structure and mechanics causing complications like acetabular shift and sacroiliitis.…”

Section: Introductionmentioning

confidence: 99%

Three-dimensional-printed customized prosthesis for pubic defect: prosthesis design and surgical techniques

Zhang

et al. 2020

J Orthop Surg Res

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Background: This study is to describe the detailed design and surgical techniques of three-dimensional (3D)printed customized prosthesis for pubic bone defect. Patients and methods: Five patients under type III resections were included in this study. Based on radiography data, 3D pelvic model was established and virtual surgery was simulated. Detailed anatomy data were measured including the size and arc of normal pubis, the size of residual bone in acetabular side. Different fixation ways were considered according to shape of defect. After features modification and porous structure design, prostheses were fabricated. The osteotomy guides and plastic models were used during surgery. Result: Of 5 cases, the prostheses consist of the type with stem (3, 60%) and the type without stem (2, 40%). Mean follow-up period was 13.6 months (range, 8-24 months). For partial pubis removed cases, the mean length and width of narrowest part of normal superior pubis were 13.19 mm (range, 12.51-14.12 mm) and 7.80 mm (range, 7.18-8.26 mm) respectively. Mean arc of normal pubis was 2.71 rad (range, 2.66-2.73 rad). For the entire pubis resection cases, the mean diameter of narrowest parts and length of normal superior pubis were 11.52 mm (range, 11.13-11.91 mm) and 64.78 mm (range, 63.46-66.09 mm), while the diameter of narrowest part and length of normal inferior pubis were 7.37 mm (range, 7.20-7.54 mm) and 86.43 mm (range, 84.28-88.57 mm). Mean length and arc of intramedullary stem was 20 mm (range, 18-21 mm) and 2.7 rad. Mean screw holes number was 6.3 (range, 6-7) while ultimate screws number in surgeries was 4.3 (range, 4-5). Porous structure with 600-μm-pore size and 70% porosity was applied in parts of contact with residual bone. Conclusion: 3D-printed customized prostheses could be a feasible option to reconstruct bone defect after type III resection. The design of 3D-printed customized prostheses is a multi-step process which is based on strict anatomic measurement.

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Innovative Techniques in Pelvic Reconstructions

Park

Shah

Hornicek

2021

Surgery of Pelvic Bone Tumors

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

Cited by 21 publications

References 17 publications

Three-dimensional-printed customized prosthesis for pubic defect: Clinical outcomes in 5 cases at a mean follow-up of 17 months

Three-dimensional-printed customized prosthesis for pubic defect: Clinical outcomes in 5 cases at a mean follow-up of 17 months

Three-dimensional-printed customized prosthesis for pubic defect: prosthesis design and surgical techniques

Innovative Techniques in Pelvic Reconstructions

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