Pelvic massive allograft reconstruction after bone tumour resection

Int Orthop. 2012 Dec;36(12):2529-36. doi: 10.1007/s00264-012-1677-4. Epub 2012 Oct 23.

Abstract

Purpose: The purpose of this report was to retrospectively review a series treated with pelvic tumour resection and massive allograft reconstruction, and determine survival of patients and implants, functional results and morbidity of surgical technique.

Methods: From 1999, 33 patients underwent pelvic tumour resection and massive allograft reconstruction. The mean age was 40 years (range, 14-72) and 29 patients had a primary malignant tumour. The resection involved the acetabular area in all but three patients.

Results: At a median follow-up of 33 months (range, two-143) four patients had local recurrence. The morbidity was high: five deep infections (15 %), requiring two allograft removal, six hip dislocations (18 %), eight sciatic nerve palsy (24 %), persistent in six cases, and two loosening of the acetabular component. Implant survival was 87.3 % at last follow up. The cumulative overall patient's survival was 41.5 % at five and ten years. The average MSTS functional score was 70 % (range, 54-100 %) when the acetabulum was preserved while it was 61 % (30-100 %) in patients with acetabular resection.

Conclusion: In conclusion, pelvic allografts represent a valid option for reconstruction after resection of pelvic tumours but due to the associated morbidity, patients should be carefully selected.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Bone Neoplasms / mortality
  • Bone Neoplasms / surgery*
  • Chondrosarcoma / mortality
  • Chondrosarcoma / surgery*
  • Female
  • Follow-Up Studies
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Orthopedic Procedures / methods*
  • Osteosarcoma / mortality
  • Osteosarcoma / surgery*
  • Pelvic Bones / surgery*
  • Plastic Surgery Procedures / methods*
  • Retrospective Studies
  • Sarcoma, Ewing / mortality
  • Sarcoma, Ewing / surgery*
  • Survival Rate
  • Transplantation, Homologous
  • Treatment Outcome
  • Young Adult