Case Report: Reconstruction After Anterior Pubic Hemipelvectomy

Murphy, B. A.; Thillainadesan, Tharsa; Robinson, K. B.; Clarke, Alison L.; Choong, Peter

doi:10.3389/fsurg.2021.585600

Cited by 3 publications

(4 citation statements)

References 30 publications

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“…A flexible reconnection of the pubic symphysis combined with a rigid structure to provide muscle attachment points seems to be an ideal solution. Based on previous work demonstrating that 3D-printed porous structures could support soft tissue ingrowth ( Guder et al, 2021 ; Xu et al, 2022 ), we infer that by relying on ordered micromotion during ambulation and tension–stress effect ( Pilliar et al, 1986 ), the newborn strong, well-organized fibrous tissue could mimic native arcuate ligaments after elastic reconstruction ( Murphy et al, 2021 ), albeit lacking histological verification.…”

Section: Discussionmentioning

confidence: 95%

Reconstruction with 3D-printed prostheses after type I + II + III internal hemipelvectomy: Finite element analysis and preliminary outcomes

Peng¹,

Shen²,

Li³

et al. 2023

Front. Bioeng. Biotechnol.

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Background: Prosthetic reconstruction after type I + II+ III internal hemipelvectomy remains challenging due to the lack of osseointegration and presence of giant shear force at the sacroiliac joint. The purpose of this study was to evaluate the biomechanical properties of the novel 3D-printed, custom-made prosthesis with pedicle screw–rod system and sacral tray using finite element analysis.Methods: Four models that included one intact pelvis were established for validation. Forces of 500 N and 2,000 N were applied, respectively, to simulate static bipedal standing and the most loaded condition during a gait cycle. Biomechanical analysis was performed, and the results were compared; the preliminary outcomes of four patients were recorded.Results: For the reconstructed hemipelvis, stress was mainly concentrated on the sacral screws, bone–prosthesis interface, and upper endplate of the L5 vertebra. The optimization of the design with the sacral tray structure could decrease the peak stress of the sacral screws by 18.6%, while the maximal stress of the prosthesis increased by 60.7%. The addition of the lumbosacral pedicle–rod system further alleviated stress of the sacral screws and prosthesis by 30.2% and 19.4%, respectively. The site of peak stress was contemporaneously transferred to the connecting rods within an elastic range. In the retrospective clinical study, four patients who had undergone prosthetic reconstruction were included. During a follow-up of 16.6 ± 7.5 months, the walking ability was found preserved in all patients who are still alive and no prosthesis-related complications had occurred except for one hip dislocation. The Musculoskeletal Tumor Society (MSTS) score was found to be 19.5 ± 2.9.Conclusion: The novel reconstructive system yielded favorable biomechanical characteristics and demonstrated promising preliminary outcomes. The method can be used as a reference for reconstruction after type I + II + III hemipelvectomy.

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Section: Discussionmentioning

confidence: 95%

Reconstruction with 3D-printed prostheses after type I + II + III internal hemipelvectomy: Finite element analysis and preliminary outcomes

Peng¹,

Shen²,

Li³

et al. 2023

Front. Bioeng. Biotechnol.

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“…Chondrosarcomas encompasses neoplasms derived from mesenchymal lineage cells and are characterized by the production of a cartilaginous matrix that may arise de novo or develop as a sequel to pre-existing benign cartilaginous neoplasms [ 1 , 2 ]. While its prevalence is eclipsed by myeloma and osteosarcoma, it ranks as the third most common primary malignant bone tumor [ [2] , [3] , [4] ].…”

Section: Introductionmentioning

confidence: 99%

“…When often encountered nocturnal pain, frequently of prolonged duration [ 4 ] is the cardinal symptom. In the context of pelvic chondrosarcomas due to their intricate anatomical localization and proximity to critical structures such as the bladder, rectum, and neurovascular bundles, when they reach large proportions clinical manifestations can include a palpable mass, pathological fractures, or symptoms attributed to a mass effect, including neural compression [ 1 , 4 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

“…The therapeutic cornerstone for chondrosarcomas is surgical resection, a modality of choice due to the inherent resistance of these tumors to conventional radiotherapy and chemotherapy [ 1 , 2 , 4 , 6 , 8 ]. This requires comprehensive surgical procedures, including hindquarter amputation or internal hemipelvectomy, aimed at ensuring complete extirpation with wide surgical margins, thereby mitigating the risk of recurrence [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

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Grade III chondrosarcoma of the left iliopubic branch: A case report

Núñez-Rocha,

Gómez-Carrillo,

Estupiñan

et al. 2024

International Journal of Surgery Case Reports

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Three‐Dimensional Printed Prosthesis Reconstructs Bilateral Type III Pelvic Defect After Malignant Tumors Resection

He,

Luo,

Zou

et al. 2024

Orthopaedic Surgery

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ObjectiveType III hemipelvectomy and reconstruction are challenging. Several reconstruction options, including autologous soft tissue, prosthesis patch, autologous, or allograft, were reported, but a variety of shortcomings limited their application. Three‐dimensional (3D)‐printed prosthesis was designed to reconstruct the unilateral Type III pelvic defect and had favorable clinical outcomes. However, the reconstruction method for bilateral Type III pelvic defect was few reported. This study aims to design a bilateral pubis prosthesis and evaluate the early clinical outcomes and complications.MethodsWe retrospectively collected patients receiving 3D‐printed bilateral pubis prosthesis reconstruction after malignant tumor resection between 2017 and 2021. Demographics, anatomic data, operation time, blood loss, and clinical outcomes of patients were analyzed. The Musculoskeletal Tumor Society‐93 (MSTS‐93) score was performed to evaluate the function and complications were recorded.ResultsFour patients, including three for females and one for males, were enrolled in this study. Prosthesis was designed according to the pelvic anatomical data. The mean operation time and blood loss were 308.8 min (range, 240–400 min) and 655 mL (range, 400–1100 mL), respectively. The average follow‐up was 15.5 months (range, 12–16 months). The mean MSTS was 28.5 (28–29). One patient had incision necrosis postoperatively. No hernia, prosthesis displacement, or implant failure occurred during follow‐up. Four patients with 15 interfaces showed good osteointegration.Conclusions3D‐printed bilateral pubis prosthesis could restore the integrity and stability of pelvic ring and improve limb function. Meanwhile, this reconstruction option provided a rigid bony‐soft support to prevent the development of hernia. In all, 3D‐printed bilateral pubis prosthesis is recommended to be a favorable selection for Type III pelvic defect reconstruction.

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Case Report: Reconstruction After Anterior Pubic Hemipelvectomy

Cited by 3 publications

References 30 publications

Reconstruction with 3D-printed prostheses after type I + II + III internal hemipelvectomy: Finite element analysis and preliminary outcomes

Reconstruction with 3D-printed prostheses after type I + II + III internal hemipelvectomy: Finite element analysis and preliminary outcomes

Grade III chondrosarcoma of the left iliopubic branch: A case report

Three‐Dimensional Printed Prosthesis Reconstructs Bilateral Type III Pelvic Defect After Malignant Tumors Resection

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