Archives of Orthopaedic and Trauma Surgery

, Volume 123, Issue 7, pp 340–344 | Cite as

Tumors of the pelvis: complications after reconstruction

  • A. Hillmann
  • C. Hoffmann
  • G. Gosheger
  • R. Rödl
  • W. Winkelmann
  • T. OzakiEmail author
Original Article



Complications after pelvic sarcoma surgery are frequent; however, the reports on complications are limited. Results of the authors' experience with 110 primary pelvic tumor resections and methods to achieve low complication rates for pelvic reconstruction are reported.

Materials and methods

From 1982 to 1996, 110 patients with pelvic sarcoma (42 Ewing sarcomas, 40 chondrosarcomas, 21 osteosarcomas, and 7 other malignant tumors) underwent surgery. Sixteen patients underwent implantation of a hemipelvic megaprosthesis, 13 patients had implantation of an allograft for sacroiliac arthrodesis, 12 patients had implantation of an autograft for sacroiliac arthrodesis, and 17 patients underwent hip transposition. There were 9 hindquarter amputations, 6 implantations of allograft and total hip endoprosthesis, 1 implantation of prosthesis with autograft, and 1 implantation of allograft and autograft. No skeletal reconstruction was done in 35 patients.


Postoperative function was as follows: 37% in patients with prosthesis, 60% in allograft, 66% in autograft, 66% in hip transposition, 37% in amputation, and 79% without reconstruction. In total, 10/16 patients with prosthetic replacement, 9/13 with allograft implantation, 4/12 with autograft implantation, 7/17 with hip transposition, 5/9 with amputation, 6/6 with prosthesis and allograft, and 12/35 without skeletal reconstruction had complications. Frequent complications depending on the reconstruction were infection in 6/10 prostheses and in 5/13 allografts, leg length discrepancy in 2/12 autografts and 4/17 hip transpositions, hematoma in 3/9 amputations, and infection (6) and skin problems (5) in 6 prostheses with allograft.


Because of the small number of complications and good function, autograft implantation after iliac resection and hip transposition after acetabular resection are advisable.


Pelvis reconstruction Complication Sarcoma 


  1. 1.
    Ahrens S, Hoffmann C, Jabar S, Braun-Munzinger G, Paulussen M, Dunst J, Rube C, Winkelmann W, Heinecke A, Gobel U, Winkler K, Harms D, Treuner J, Jurgens H (1999) Evaluation of prognostic factors in a tumor volume-adapted treatment strategy for localized Ewing sarcoma of bone: the CESS 86 experience. Cooperative Ewing Sarcoma Study. Med Pediatr Oncol 32:186–195CrossRefPubMedGoogle Scholar
  2. 2.
    Bielack S, Kempf-Bielack B, Schwenzer D, Birkfellner T, Delling G, Ewerbeck V, Exner GU, Fuchs N, Gobel U, Graf N, Heise U, Helmke K, Hochstetter ARvon , Jurgens H, Maas R, Munchow N, Salzer-Kuntschik M, Treuner J, Veltmann U, Werner M, Winkelmann W, Zoubek A, Kotz R (1999) Neoadjuvant therapy for localized osteosarcoma of extremities. Results from the Cooperative osteosarcoma study group COSS of 925 patients (in German). Klin Padiatr 211:260–270PubMedGoogle Scholar
  3. 3.
    Campanacci M, Capanna R (1991) Pelvic resections: the Rizzoli Institute experience. Orthop Clin North Am 22:65–86PubMedGoogle Scholar
  4. 4.
    Enneking WF (1987) Modification of the system for functional evaluation of surgical management of musculoskeletal tumors. In: Enneking WF (ed) Limb salvage in musculoskeletal oncology. Bristol-Myers/Zimmer Orthopaedic Symposium. Churchill-Livingstone, New York, pp 626–682Google Scholar
  5. 5.
    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 286:241–246PubMedGoogle Scholar
  6. 6.
    Gradinger R, Rechl H, Hipp E (1991) Pelvic osteosarcoma. Resection, reconstruction, local control, and survival statistics. Clin Orthop 270:149–158PubMedGoogle Scholar
  7. 7.
    Johnson JT (1978) Reconstruction of the pelvic ring following tumor resection. J Bone Joint Surg Am 60:747–751PubMedGoogle Scholar
  8. 8.
    Nielsen HK, Veth RP, Oldhoff J, Koops HS, Scales JT (1985) Resection of a peri-acetabular chondrosarcoma and reconstruction of the pelvis. A case report. J Bone Joint Surg Br 67:413–415PubMedGoogle Scholar
  9. 9.
    O'Connor MI, Sim FH (1989) Salvage of the limb in the treatment of malignant pelvic tumors. J Bone Joint Surg Am 71:481–494PubMedGoogle Scholar
  10. 10.
    Ozaki T, Hillmann A, Bettin D, Wuisman P, Winkelmann W (1996) High complication rates with pelvic allografts. Experience of 22 sarcoma resections. Acta Orthop Scand 67:333–338Google Scholar
  11. 11.
    Ozaki T, Hillmann A, Lindner N, Blasius S, Winkelmann W (1997) Chondrosarcoma of the pelvis. Clin Orthop :226–239Google Scholar
  12. 12.
    Ozaki T, Hillmann A, Winkelmann W (1998) Treatment outcome of pelvic sarcomas in young children: orthopaedic and oncologic analysis. J Pediatr Orthop 18:350–355CrossRefPubMedGoogle Scholar
  13. 13.
    Stephenson RB, Kaufer H, Hankin FM (1989) Partial pelvic resection as an alternative to hindquarter amputation for skeletal neoplasms. Clin Orthop 242:201–211PubMedGoogle Scholar
  14. 14.
    Uchida A, Myoui A, Araki N, Yoshikawa H, Ueda T, Aoki Y (1996) Prosthetic reconstruction for periacetabular malignant tumors. Clin Orthop 326:238–245PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2003

Authors and Affiliations

  • A. Hillmann
    • 1
  • C. Hoffmann
    • 1
  • G. Gosheger
    • 1
  • R. Rödl
    • 1
  • W. Winkelmann
    • 1
  • T. Ozaki
    • 2
    Email author
  1. 1.Department of OrthopedicsWestfälische Wilhelms-UniversitätMünsterGermany
  2. 2.Study of Biofunctional Recovery and ReconstructionOkayama University Graduate School of Medicine and DentistryOkayamaJapan

Personalised recommendations