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Alloprosthetic Composite is a Suitable Reconstruction After Periacetabular Tumor Resection

  • Clinical Research
  • Published:
Clinical Orthopaedics and Related Research®

Abstract

Background

Resection of a tumor of the pelvis is most disabling when the acetabulum is excised and a durable reconstruction of the defect is hard to achieve. All available methods are associated with frequent complications. Few large series have been published, and fewer have focused entirely on complete resections of the acetabulum. The use of an allograft-prosthetic composite allows customization on the operating table. However, while such composites restore anatomy and function of the pelvis the use of pelvic allografts is controversial and the durability is unknown.

Questions/purposes

We therefore examined (1) the frequency of allograft and prosthetic failure, (2) positive and negative factors influencing the survival of the allograft prosthetic composite, and (3) function of patients with this reconstruction.

Patients and Methods

We retrospectively evaluated 35 patients who had resection of the entire acetabulum and reconstruction with an allograft-prosthetic composite. Function was scored by the Musculoskeletal Tumor Society system. Followup in 24 survivors averaged 120 months (range, 61–188 months).

Results

Greater than 75% of the allografts were still in place at last followup, and the original prosthetic reconstruction was still in place in 56%. Infection was an important negative factor for allograft survival. The average functional score was 72%, with better mean scores for patients who had reconstruction with a stemmed cup and an artificial ligament (average 89%).

Conclusions

An allograft-prosthetic composite provides a versatile substitution of the pelvis and hip, with functional scores approximately 75% of normal.

Level of Evidence

Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

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Acknowledgment

We thank Elettra Pignotti for reviewing all statistical data.

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Authors and Affiliations

  1. Orthopaedic Surgery, Department of Musculoskeletal Oncology, Istituto Ortopedico Rizzoli, Bologna, Italy

    Davide Donati MD, Claudia Di Bella MD, Tommaso Frisoni MD & Luca Cevolani MD

  2. Orthopedic Surgery, Newton Wellesley Hospital, 2000 Washington St. Suite 544, Newton, MA, 02462, USA

    Henry DeGroot MD

Authors
  1. Davide Donati MD
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  2. Claudia Di Bella MD
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  3. Tommaso Frisoni MD
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  4. Luca Cevolani MD
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  5. Henry DeGroot MD
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Corresponding author

Correspondence to Henry DeGroot MD.

Additional information

Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.

Each author certifies that his or her institution approved the human protocol for this investigation and that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained.

This work was performed at the Department of Musculoskeletal Oncology, Istituto Ortopedico Rizzoli, Bologna, Italy.

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Donati, D., Di Bella, C., Frisoni, T. et al. Alloprosthetic Composite is a Suitable Reconstruction After Periacetabular Tumor Resection. Clin Orthop Relat Res 469, 1450–1458 (2011). https://doi.org/10.1007/s11999-011-1799-9

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  • DOI: https://doi.org/10.1007/s11999-011-1799-9

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