[Reconstruction with a new type of combined reconstruction following excision of periacetabular tumors].

Abstract

To evaluate the reconstructive effect of a new pattern of combined reconstruction after periacetabular tumor resections.
Between March 2001 and March 2007, tumor resections and new pattern of combined reconstructions which consisted of screw-rod system, acetabular reinforcement shell, antibiotic cement and total hip arthroplasty techniques were performed in 23 patients with periacetabular tumors. There were 7 females and 16 males. The mean age was 43 years (range, 16-78 years). Seventeen patients had primary malignant tumors including 7 chondrosarcomas, 4 osteosarcomas, 2 Ewing sarcomas, 2 malignant fibrohistiocytomas, 1 malignant Schwannomas, and 1 synovial sarcoma. Other primary tumors were 2 giant cell tumors and 1 aggressive osteoblastoma. Three metastatic bone tumors were also included in this study, and the original sites were thyroid, breast, and ovary.
According to Enneking's staging system, there were 1 case in IA, 5 cases in IB, 3 cases in IIA, and 8 cases in IIB. Three primary benign bone tumors belonged to stage III. The average follow-up was 36. 8 months (range, 9-73 months) in the patients with primary tumors. The survival time in 3 patients with metastatic disease were between 9.6 months and 36. 6 months. There were 4 patients who had local recurrence, 5 patients had pulmonary metastases, and 5 patients died of disease. No wound complication was encountered. The postoperative complications included 3 cases of screw loosening, 2 cases of prosthetic dislocation, 3 cases of leg length discrepancy, 2 cases of deep vein thrombosis, 1 case of partial neuropraxia of sciatic nerve. The complication rate related to implants was 21.7%. The average MSTS functional score was 68% for all patients at 6 months postoperatively, and 62% for 6 patients with follow-up time more than 5 years.
This new combined reconstruction is an effective way to rebuild pelvic ring and maintain hip function with low complication rate after periacetabular tumor resections.