[Reconstruction of the hemipelvis with saddle prosthesis after excision of malignant tumors around the pelvis and acetabulum: a report of 12 cases]

Abstract

Background & objective: Malignant tumors around the pelvis and acetabulum locate deeply with complex anatomic structure, meanwhile, the resection area involves the weight-loading alignment. Therefore, tumor resection plus acetabular joint reconstruction is a complicated operation. This study was to summarize our experience of tumor resection plus prosthesis reconstruction of the acetabular joint for this disease.

Methods: Clinical data of 12 patients with malignant tumors around the pelvis and acetabulum, treated with tumor resection plus prosthesis reconstruction of the acetabular joint from 1995 to 2006, were reviewed. The characteristics of the operating for this disease were analyzed in terms of preoperative preparation, operating strategy, prosthesis design, operating procedure, acetabular reconstruction, and postoperative rehabilitation.

Results: The patients were followed for 8-86 months, with a median of 46 months. Of the 4 patients with tumor relapse, 2 osteosarcoma patients died of lung metastasis at 15 months and 22 months after operation; 1 chondrosarcoma patient relapsed locally at 26 months after operation and died at 38 months after operation; 1 giant cell tumor patient relapsed locally at 13 months after operation and was treated by clearance of focal lesion, and survived tumor-freely till the end of follow-up. The other 9 patients still survived tumor-freely till the end of follow-up. The 1-year survival rate was 75.0%; the 3-and 5-year survival rates were 33.3%; the 7-year survival rate was 25.0%. According to Harris scoring criteria after total hip replacement, 3 patients scored 60-69, 5 scored 70-79, and 4 scored 80-90 in limb function.

Conclusions: Pelvic tumor resection and prosthesis reconstruction of the acetabular joint has the characteristics of difficulty and high-risk. For bone tumors with relatively low malignancy, this surgical treatment is an ideal option.