Skip to main content
Log in

Reconstruction with modular hemipelvic prosthesis for the resection of solitary periacetabular metastasis

  • Orthopaedic Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Background

The outcomes of patients with solitary metastasis around the acetabulum who received en bloc resection and reconstruction are unclear. The purpose is to evaluate the oncologic results, complications, and functional outcomes in these patients.

Methods

Fifteen patients who underwent periacetabular resection and modular endoprosthetic reconstruction were reviewed retrospectively.

Results

Eleven patients were alive and four had died of their respective diseases. The mean follow-up time for the living patients and the non-surviving patients was 32 and 11 months, respectively. One of the three patients presented with local recurrence received hindquarter amputation. Five patients with superficial wound problem were treated with debridement and were healed eventually. Two patients who had hip dislocation received closed reduction. Pain was relieved in most patients, and ten patients were able to walk outside their house. The average MSTS 93 score was 20.9 of a total of 30 points (69.7%). When evaluated according to the modified Allan scoring system, postoperative scores on pain, independence, and mobility had significant improvement.

Conclusion

En bloc tumor resection and reconstruction with modular hemipelvic prosthesis in patients who had a solitary periacetabular metastasis can provide long-term survive, tumor local control, low complication rate, and good functional recovery.

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

Access this article

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

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Landis SH, Murray T, Bolden S et al (1998) Cancer statistics, 1998. CA Cancer J Clin 48:6–29

    Article  PubMed  CAS  Google Scholar 

  2. Baloch KG, Grimer RJ, Carter SR et al (2000) Radical surgery for the solitary bony metastasis from renal-cell carcinoma. J Bone Joint Surg Br 82:62–67

    Article  PubMed  CAS  Google Scholar 

  3. Sakaura H, Hosono N, Mukai Y et al (2004) Outcome of total en bloc spondylectomy for solitary metastasis of the thoracolumbar spine. J Spinal Disord Tech 17:297–300

    Article  PubMed  Google Scholar 

  4. Tomita K, Kawahara N, Baba H et al (1994) Total en bloc spondylectomy for solitary spinal metastases. Int Orthop 18:291–298

    Article  PubMed  CAS  Google Scholar 

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

    Article  PubMed  CAS  Google Scholar 

  6. Harrington K (1981) The management of acetabular insufficiency secondary to metastatic malignant disease. J Bone Joint Surg Am 63:653–664

    PubMed  CAS  Google Scholar 

  7. Witte D, Bernd L, Bruns J et al (2009) Limb-salvage reconstruction with MUTARS hemipelvic endoprosthesis: a prospective multicenter study. Eur J Surg Oncol 35:1318–1325

    Article  PubMed  CAS  Google Scholar 

  8. Yasko AW, Rutledge J, Lewis VO et al (2007) Disease- and recurrence-free survival after surgical resection of solitary bone metastases of the pelvis. Clin Orthop Relat Res 459:128–132

    Article  PubMed  Google Scholar 

  9. Allan DG, Bell R, Davis A et al (1995) Complex acetabular reconstruction for metastatic tumor. J Arthroplasty 10:301–306

    Article  PubMed  CAS  Google Scholar 

  10. Marco RAW, Sheth DS, Boland PJ et al (2000) Functional and oncological outcome of acetabular reconstruction for the treatment of metastatic disease. J Bone Joint Surg Am 82:642–651

    PubMed  CAS  Google Scholar 

  11. Nilsson J, Gustafson P, Fornander P et al (2000) The Harrington reconstruction for advanced periacetabular metastatic destruction: good outcome in 32 patients. Acta Orthop Scand 71:591–596

    Article  PubMed  CAS  Google Scholar 

  12. Eckardt JJ, Kabo JM, Kelly CM et al (2003) Endoprosthetic reconstructions for bone metastases. Clin Orthop Relat Res 415S:254–262

    Article  Google Scholar 

  13. Benevenia J, Cyran FP, Biermann JS et al (2004) Treatment of advanced metastatic lesions of the acetabulum using the saddle prosthesis. Clin Orthop Relat Res 426:23–31

    Article  PubMed  Google Scholar 

  14. Falkinstein Y, Ahlmann ER, Menendez LR (2008) Reconstruction of type II pelvic resection with a new peri-acetabular reconstruction endoprosthesis. J Bone Joint Surg Br 90:371–376

    Article  PubMed  CAS  Google Scholar 

  15. Guo W, Li D, Tang X et al (2007) Reconstruction with modular hemipelvic prostheses for periacetabular tumor. Clin Orthop Relat Res 461:180–188

    PubMed  Google Scholar 

  16. Prosser GH, Baloch KG, Tillman RM et al (2005) Does curettage without adjuvant therapy provide low recurrence rates in giant-cell tumors of bone? Clin Orthop Relat Res 435:211–218

    Article  PubMed  Google Scholar 

  17. Enneking WF, Dunham WK (1978) Resection and reconstruction for primary neoplasms involving the innominate bone. J Bone Joint Surg Am 60:731–746

    PubMed  CAS  Google Scholar 

  18. Enneking WF, Dunham W, Gebhardt MC et al (1993) A system for the functional evaluation of reconstructive procedures after surgical treatment of tumors of the musculoskeletal system. Clin Orthop Relat Res 286:241–246

    PubMed  Google Scholar 

  19. Dürr HR, Müller PE, Lenz T et al (2002) Surgical treatment of bone metastases in patients with breast cancer. Clin Orthop Relat Res 396:191–196

    Article  PubMed  Google Scholar 

  20. Fuchs B, Trousdale RT, Rock MG (2005) Solitary bony metastasis from renal cell carcinoma: significance of surgical treatment. Clin Orthop Relat Res 431:187–192

    Article  PubMed  Google Scholar 

  21. Jung ST, Ghert MA, Harrelson JM et al (2003) Treatment of osseous metastases in patients with renal cell carcinoma. Clin Orthop Relat Res 409:223–231

    Article  PubMed  Google Scholar 

  22. Lin PP, Mirza AN, Lewis VO et al (2007) Patient survival after surgery for osseous metastases from renal cell carcinoma. J Bone Joint Surg Am 89:1794–1801

    Article  PubMed  Google Scholar 

  23. Wedin R (2001) Surgical treatment for pathologic fracture. Acta Orthop Scand Suppl 72:2p.,1–29

    Google Scholar 

  24. Sugiura H, Yamada K, Sugiura T et al (2008) Predictors of survival in patients with bone metastasis of lung cancer. Clin Orthop Relat Res 466:729–736

    Article  PubMed  Google Scholar 

  25. Hirano Y, Oda M, Tsunezuka Y et al (2005) Long-term survival cases of lung cancer presented as solitary bone metastasis. Ann Thorac Cardiovasc Surg 11:401–404

    PubMed  Google Scholar 

  26. Clayer M (2010) The survivorship of protrusio cages for metastatic disease involving the acetabulum. Clin Orthop Relat Res 468:2980–2984

    Article  PubMed  Google Scholar 

  27. Ho L, Ahlmann ER, Menendez LR (2010) Modified Harrington reconstruction for advanced periacetabular metastatic disease. J Surg Oncol 101:170–174

    PubMed  Google Scholar 

Download references

Conflict of interest

No benefits have been received from a commercial party related directly or indirectly to the subject of this article. This study complies with all current relevant laws in China, where this report was produced.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Wei Guo.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Tang, X., Guo, W. & Ji, T. Reconstruction with modular hemipelvic prosthesis for the resection of solitary periacetabular metastasis. Arch Orthop Trauma Surg 131, 1609–1615 (2011). https://doi.org/10.1007/s00402-011-1359-5

Download citation

  • Received:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00402-011-1359-5

Keywords

Navigation