Skip to main content

Advertisement

SpringerLink
Log in

To reconstruct the hemipelvis and acetabulum with homolateral proximal femur: a feasible way for hip reconstruction after tumorectomy involving the acetabulum

  • Original Article
  • Published:
European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Background

Hemipelvic defect could be reconstructed with homolateral proximal femur, and an acetabulum could be smartly created in the trochanter region. Several issues concerning the peculiar reconstruction of hemipelvis and acetabulum with autograft of homolateral proximal femur have not been revealed clearly yet.

Methods

Seventy cases of radiographic data were investigated and measured retrospectively to determine the maximum diameter that could be contained in the trochanter. A dual-energy X-ray absorptiometry was employed to detect bone mineral density of natural acetabulum and trochanter on eight volunteers to reflect the differences of bone mineral density and determine whether postoperative protection is needed. Finally, a mock operation was designed to reflect the reconstruction method.

Results

The section of great trochanter was round and the max diameter was 44.2 ± 5.75 mm averagely. The bone mineral density of natural acetabulum was 1.224 ± 0.183 g/cm3 while 0.866 ± 0.132 g/cm3 in the trochanter region, which was lower statistically than the former. The hemipelvis and acetabulum could be well reconstructed with autograft of homolateral proximal femur through mock operations.

Conclusions

It is feasible to reconstruct the hemipelvis and hip joint with autologous homolateral proximal femur combined with normal-size total hip replacement. Postoperative protection is mandatory for the new acetabulum could not replace the natural one in the level of bone density.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Butler CE, Rodriguez-Bigas MA (2005) Pelvic reconstruction after abdominoperineal resection: is it worthwhile? Ann Surg Oncol 12:91–94

    Article  PubMed  Google Scholar 

  2. Hillmann A, Hoffmann C, Gosheger G, Rödl R, Winkelmann W, Ozaki T (2003) Tumors of the pelvis: complications after reconstruction. Arch Orthop Trauma Surg 123:340–344

    Article  PubMed  CAS  Google Scholar 

  3. Hoffmann C, Gosheger G, Gebert C, Jürgens H, Winkelmann W (2006) Functional results and quality of life after treatment of pelvic sarcomas involving the acetabulum. J Bone Joint Surg Am 88:575–582

    Article  PubMed  CAS  Google Scholar 

  4. Wunder JS, Ferguson PC, Griffin AM, Pressman A, Bell RS (2003) Acetabular metastases: planning for reconstruction and review of results. Clin Orthop Relat Res 415S:S187–S197

    Article  Google Scholar 

  5. Guo W, Li D, Tang X, Yang Y, Ji T (2007) Reconstruction with modular hemipelvic prostheses for periacetabular tumor. Clin Orthop Relat Res 461:180–188

    PubMed  Google Scholar 

  6. 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 396:197–205

    Article  PubMed  Google Scholar 

  7. Bruns J, Luessenhop SL, Dahmen G (1997) Internal hemipelvectomy and endoprosthetic pelvic replacement: long-term follow-up results. Arch Orthop Trauma Surg 116:27–31

    Article  PubMed  CAS  Google Scholar 

  8. Turcotte RE (2007) Endoprosthetic replacement for bone tumors: review of the most recent literature. Curr Opin Orthop 18:572–578

    Article  Google Scholar 

  9. Beadel GP, McLaughlin CE, Wunder JS, Griffin AM, Ferguson PC, Bell RS (2005) Outcome in two groups of patients with allograft-prosthetic reconstruction of pelvic tumor defects. Clin Orthop Relat Res 438:30–35

    Article  PubMed  Google Scholar 

  10. Harrington KD (1992) The use of hemipelvic allografts or autoclaved grafts for reconstruction after wide resections of malignant tumors of the pelvis. J Bone Joint Surg Am 74:331–341

    PubMed  CAS  Google Scholar 

  11. Kim HS, Kim KJ, Han I, Oh JH, Lee SH (2007) The use of pasteurized autologous grafts for periacetabular reconstruction. Clin Orthop Relat Res 464:217–223

    PubMed  Google Scholar 

  12. Nagoya S, Usui M, Wada T, Yamashita T, Ishii S (2000) Reconstruction and limb salvage using a free vascularised fibular graft for periacetabular malignant bone tumours. J Bone Joint Surg Br 82:1121–1124

    Article  PubMed  CAS  Google Scholar 

  13. Nishida J, Shiraishi H, Okada K, Ehara S, Shimamura T (2006) Vascularized iliac bone graft for iliosacral bone defect after tumor resection. Clin Orthop Relat Res 447:145–151

    Article  PubMed  Google Scholar 

  14. Sakuraba M, Kimata Y, Iida H, Beppu Y, Chuman H, Kawai A (2005) Pelvic ring reconstruction with the double-barreled vascularized fibular free flap. Plast Reconstr Surg 116:1340–1345

    Article  PubMed  CAS  Google Scholar 

  15. Puget J (1994) Les métastases cotyloïdiennes: traitement des métastases cotyloidïennes par autogreffe à partir de l’extrémité supérieure du fémur homolatéral. Orthop Traumatol 4:35–38 (in French)

    Article  Google Scholar 

  16. Puget J, Utheza G (1986) Reconstruction de l’os iliaque à l’aide du fémur homolatéral après résection pour tumeur pelvienne. Rev Chir Orthop 72:151–155 (in French)

    PubMed  CAS  Google Scholar 

  17. Biau DJ, Thévenin F, Dumaine V, Babinet A, Tomeno B, Anract P (2009) Ipsilateral femoral autograft reconstruction after resection of a pelvic tumor. J Bone Joint Surg Am 91:142–151

    Article  PubMed  Google Scholar 

  18. Gao YS, Mei J, Ni M (2009) Alternative biological reconstruction for periacetabular bone defects? Eur J Orthop Surg Traumatol 19:135

    Article  Google Scholar 

  19. 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 60:719–730

    PubMed  CAS  Google Scholar 

  20. Aljassir F, Beadal GP, Turcotte RE, Griffin AM, Bell RS, Wunder JS et al (2005) Outcome after sarcoma resection reconstructed with saddle prosthesis. Clin Orthop Relat Res 438:36–41

    Article  PubMed  Google Scholar 

  21. Benevenia J, Cyran FP, Biermann JS, Patterson FR, Leeson MC (2004) Treatment of advanced metastatic lesions of the acetabulum using the saddle prosthesis. Clin Orthop Relat Res 426:23–31

    Article  PubMed  Google Scholar 

  22. Combalía A, Fernández-Valencia JA, Ramón R, Segur JM, García S, Suso S (2002) Long-term results of hemipelvic allograft: report of four cases. Cell Tissue Bank 3:41–44

    Article  PubMed  Google Scholar 

  23. Sys G, Uyttendaele D, Poffyn B, Verdonk R, Verstraete L (2002) Extracorporeally irradiated autografts in pelvic reconstruction after malignant tumor resection. Int Orthop 26:174–178

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

We would like to thank Stryker China for providing us total hip and proximal femoral prosthesis, Professor Zhao-Ming Ye at Second Affiliated Hospital of Zhejiang University for his kind and helpful communications, and Dr. Yin-Bo Feng at Radiology Department of Tongji Hospital for his help in technical assistance.

Conflict of interest

No benefits and funding in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article. No author has any financial relations to the commercial parties.

Author information

Authors and Affiliations

  1. Department of Orthopedic Surgery, Shanghai Sixth People’s Hospital, Shanghai Jiao Tong University, 200233, Shanghai, China

    You-Shui Gao & Chang-Qing Zhang

  2. Department of Orthopedic Surgery, Tongji Hospital, Tongji University, 200065, Shanghai, China

    Jiong Mei, Xian-Hui Wang & Bang Dou

  3. Department of Orthopedic Surgery, Shanghai Pudong New Area People’s Hospital, 200120, Shanghai, China

    Ming Ni

Authors
  1. You-Shui Gao
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jiong Mei
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Chang-Qing Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ming Ni
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Xian-Hui Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Bang Dou
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding authors

Correspondence to Jiong Mei or Chang-Qing Zhang.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Gao, YS., Mei, J., Zhang, CQ. et al. To reconstruct the hemipelvis and acetabulum with homolateral proximal femur: a feasible way for hip reconstruction after tumorectomy involving the acetabulum. Eur J Orthop Surg Traumatol 21, 145–149 (2011). https://doi.org/10.1007/s00590-010-0684-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00590-010-0684-7

Keywords

Search

Navigation