International Orthopaedics

, Volume 36, Issue 12, pp 2529–2536 | Cite as

Pelvic massive allograft reconstruction after bone tumour resection

  • Domenico Campanacci
  • Sara ChaconEmail author
  • Nicola Mondanelli
  • Giovanni Beltrami
  • Guido Scoccianti
  • Giuseppe Caff
  • Filippo Frenos
  • Rodolfo Capanna
Original Paper



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.


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.


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.


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.


Chondrosarcoma Acetabular Component Pelvic Tumour MSTS Score Sciatic Nerve Palsy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Carter SR, Eastwood DM, Grimer RJ, Sneath RS (1990) Hindquarter amputation for tumors of the musculoskeletal system. J Bone Joint Surg Br 72(3):490–493PubMedGoogle Scholar
  2. 2.
    Bell RS, Davis AM, Wunder JS, Buconjic T, McGoveran B, Gross AE (1997) Allograft reconstruction of the acetabulum alter resection of stage-IIB sarcoma: intermediate-term results. J Bone Joint Surg Am 79(11):1663–1674PubMedGoogle Scholar
  3. 3.
    Langlais F, Lambotte JC, Thomazeau H (2001) Long-term results of hemipelvis reconstruction with allografts. Clin Orthop Relat Res 388:178–186PubMedCrossRefGoogle Scholar
  4. 4.
    Renard AJ, Veth RP, Schreuder HW, Pruszczynski M, Keller A, van Hoesel Q, Bokkerink JP (2000) The saddle prosthesis in pelvic primary and secondary musculoskeletal tumors: functional results at several postoperative intervals. Arch Orthop Trauma Surg 120:188–194PubMedCrossRefGoogle Scholar
  5. 5.
    Enneking WF, Dunham WK (1978) Resection and reconstruction for primary neoplasm involving the innominating bone. J Bone Joint Surg Am 60:731–746PubMedGoogle Scholar
  6. 6.
    Enneking WF (1966) Local resection of malignant lesions of the hip and pelvis. J Bone Joint Surg Am 48:991–1007Google Scholar
  7. 7.
    Ericsson U, Hjelmstedt A (1976) Limb-saving radical resection of chondrosarcoma of the pelvis. J Bone Joint Surg Am 58:568–570Google Scholar
  8. 8.
    Steel HH (1978) Partial or complete resection of the hemipelvis. An alternative to hindquarter amputation for periacetabular chondrosarcoma of the pelvis. J Bone Joint Surg Am 60:719–730PubMedGoogle Scholar
  9. 9.
    Delloye C, Banse X, Brichard B, Docquier P, Cornu O (2007) Pelvic reconstruction with a structural pelvic allograft alter resection of a malignant bone tumors. J Bone Joint Surg Am 89:579–587PubMedCrossRefGoogle Scholar
  10. 10.
    Donati D, Di Bella C, Frisoni T, Cevolani L, De Groot H (2011) Alloprosthetic composite is a suitable reconstruction after periacetabular tumor resection. Clin Orthop Relat Res 469:1450–1458PubMedCrossRefGoogle Scholar
  11. 11.
    Enneking WF, Spanier SS, Goodman MA (1980) A system for the surgical staging of musculoskeletal sarcoma. Clin Orthop Relat Res 153:106–120PubMedGoogle Scholar
  12. 12.
    Enneking WF, Dunham W, Gebhardt MC, Malawar M, Pritchard DJ (1993) A system for the functional evaluation of reconstructive procedures after surgical treatment of tumors of the musculoskeletal system. Clin Orthop Relat Res 286:41–46Google Scholar
  13. 13.
    Picci P, Bohling T, Bacci G et al (1997) Chemotherapy induced tumor necrosis as a prognostic factor in localized Ewing’s sarcoma of the extremities. J Clin Oncol 15:1553–1559PubMedGoogle Scholar
  14. 14.
    O’Connor MI, Sim FH (1989) Salvage of the limb in the treatment of malignant pelvis tumors. J Bone Joint Surg Am 71:481–494PubMedGoogle Scholar
  15. 15.
    Campanacci M, Capanna R (1991) Pelvis resections: the Rizzoli institute experience. Orthop Clin N Am 22:65–86Google Scholar
  16. 16.
    Cheong D, Letson GD (2011) Computer-assisted navigation and musculoskeletal sarcoma surgery. Cancer Control 18(3):171–176PubMedGoogle Scholar
  17. 17.
    Guo W, Li D, Tang X, Yang Y, Ji T (2007) Reconstruction with modular hemipelvic prostheses for periacetabular tumor. Clin Orthop Relat Res 461:180–188PubMedGoogle Scholar
  18. 18.
    Ozaki T, Hoffmann C, Hillmann A, Gosheger G, Lindner N, Winkelmann W (2002) Implantation of hemipelvic prosthesis after resection of sarcoma. Clin Orthop Relat Res 396:197–205PubMedCrossRefGoogle Scholar
  19. 19.
    Gebert C, Wessling M, Hoffmann C, Roedl R, Winkelmann W, Gosheger G, Hardes J (2011) Hip transposition as a limb salvage procedure following the resection of periacetabular tumors. J Surg Oncol 103(3):269–275PubMedCrossRefGoogle Scholar
  20. 20.
    Aljassir F, Beadel GP, Turcotte RE, Griffin AM, Bell RS, Wunder JS, Isler MH (2005) Outcome after pelvic sarcoma resection reconstructed with saddle prosthesis. Clin Orthop Relat Res 438:36–41PubMedCrossRefGoogle Scholar
  21. 21.
    Jaiswal PK, Aston WJ, Grimer RJ, Abudu A, Carter S, Blunn G, Briggs TW, Cannon S (2008) Periacetabular resection and endoprosthetic reconstruction for tumours of the acetabulum. J Bone Joint Surg Br 90–9:1222–1227Google Scholar
  22. 22.
    Fisher NE, Patton JT, GrimerRJ PD, Jeys L, Tillman RM, Abudu A, Carter SR (2011) Ice-cream cone reconstruction of the pelvis: a new type of pelvic replacement; early results. J Bone Joint Surg Br 93(5):684–688PubMedCrossRefGoogle Scholar
  23. 23.
    Biau DJ, Thévenin F, Dumaine V, Babinet A, Tomeno B, Anract P (2009) Ipsilateral femoral autograft reconstruction after resection of pelvic tumor. J Bone Joint Surg Am 91(1):142–151PubMedCrossRefGoogle Scholar
  24. 24.
    Hoffmann C, Gosheger G, Gebert C, Jurgens H, Winkelmann W (2006) Functional results and quality of life after treatment of pelvic sarcomas involving the acetabulum. J Bone Joint Surg Am 88(3):575–582PubMedCrossRefGoogle Scholar
  25. 25.
    Yoshida Y, Osaka S, Mankin HJ (2000) Hemipelvic allograft reconstruction after periacetabular bone tumor resection. J Orthop Sci 5:198–204PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  • Domenico Campanacci
    • 1
  • Sara Chacon
    • 2
    Email author
  • Nicola Mondanelli
    • 1
  • Giovanni Beltrami
    • 1
  • Guido Scoccianti
    • 1
  • Giuseppe Caff
    • 1
  • Filippo Frenos
    • 1
  • Rodolfo Capanna
    • 1
  1. 1.Ortopedia Oncologica e RicostruttivaAzienda Ospedaliera Universitaria CareggiFlorenceItaly
  2. 2.Oncologia Ortopedica TraumatologiaHospital Universitario Virgen del RocioSevilleSpain

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