Abstract
BackgroundThe treatment of periacetabular malignant bone tumours is challenging. Many methods of reconstruction after internal hemipelvectomy have been reported and each method has its own limitations. The aim of this study was to evaluate the oncological and functional outcomes of pasteurized autograft reconstruction after resection of periacetabular malignant bone tumours.MethodsTen patients (six male, four female) with periacetabular malignant tumours, who underwent resection and reconstruction with pasteurized autograft, were retrospectively reviewed. The patients’ average age at diagnosis was 40 years (range 13–65 years). There were five patients with chondrosarcoma, three with osteosarcoma, one with Ewing’s sarcoma, and one with solitary metastatic thyroid carcinoma.ResultsAt the last follow-up, seven patients were alive (six with no evidence of the primary disease and one with lung metastasis for 5 months). The three other patients died of metastasis of the primary disease with a mean survival time of 12 (range 8–17) months postoperatively. The mean follow-up time for all patients was 45 (range 8–87) months. Local recurrence rate was 10%. The mean time of bone union was 12 (range 6–21) months after the operation. The mean Musculoskeletal Tumor Society score for all living patients at the last follow-up was 70.5% (range 43.3–86.7%).ConclusionsReconstruction with pasteurized autograft is a feasible method for treating periacetabular malignant bone tumours, with satisfactory oncological and functional outcomes and a relatively low incidence of complications.
Highlights
The treatment of periacetabular malignant bone tumours is challenging
The methods for the reconstruction of the periacetabular region include (1) arthrodesis [3, 4]; (2) pseudarthrosis [3, 5, 6]; (3) cement reinforced by rods or pins [7, 8]; (4) hemipelvic prosthesis replacement [9,10,11,12,13,14,15,16,17]; (5) allograft implantation [18,19,20]; and (6) autograft implantation [8, 18, 21,22,23]
If the plane did not achieve adequate distance from the tumour in any direction because important vessels or nerves were too close to the tumour, we considered it a marginal margin
Summary
The treatment of periacetabular malignant bone tumours is challenging. Many methods of reconstruction after internal hemipelvectomy have been reported and each method has its own limitations. The aim of this study was to evaluate the oncological and functional outcomes of pasteurized autograft reconstruction after resection of periacetabular malignant bone tumours. The treatment of pelvic malignant bone tumours is still challenging because of the anatomical complexity of the pelvis and the difficulty in achieving wide surgical margins and reconstructing large bone and soft tissue defects after tumour resection, especially in the periacetabular region [1, 2]. The replacement of the extracorporeally irradiated [21, 22] or autoclaved [8, 18] tumourbearing bone has been reported by many authors to be a feasible method for reconstruction after pelvic malignant bone tumour resection. Only a few studies have reported reconstruction with pasteurized autograft for periacetabular malignant bone tumours [23, 24].
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