Ipsilateral Femoral Autograft Reconstruction After Resection of a Pelvic Tumor

Abstract

Although it has attendant complications consistent with pelvic tumor surgery, an ipsilateral femoral autograft reconstruction may be an option for reconstruction of pelvic discontinuity in a subgroup of patients following tumor resection. This innovative procedure requires longer-term follow-up studies.

Infection After Surgical Resection for Pelvic Bone Tumors: An Analysis of 270 Patients From One Institution

“…The 20% infection rate in our series of patients is lower than reported rates in some series [3,4,18,26,27,36,39,41,45,46] and greater or comparable to the experience reported in other studies [1,8,12,13,19,20,29,30,38] ( Table 3). The overall infection rate in many series varied from 10% to 47% after internal hemipelvectomy [1, 3, 4, 8, 10, 12, 13, 18-20, 23, 25-27, 29, 30, 34, 36, 38-41, 45, 46], whereas it ranged from 11% to 38% in patients who had resection and endoprosthetic reconstruction [1,3,12,19,20,26,27,36,45,46].…”

“…Known data for infections usually are derived from small case series (patients randomized for histologic diagnosis or tumor site or type of reconstruction), and this probably is attributable to the rarity of the disease and the absence of a unique modality of treatment. As reported by others [8,27], most infections occurred within 2 years of surgery with a median time to infection of 6 months.…”

Modified Harrington reconstruction for advanced periacetabular metastatic disease

“…Several different approaches to reconstruction have been proposed including variations of Harrington-type reconstruction [3][4][5][6][7][8][9][21][22][23], endoprosthetic replacement of the acetabulum (including saddle endoprosthesis) [10][11][12][13][14], autograft [17] and allograft reconstruction [24][25][26][27], arthrodesis [24,28], and resection without reconstruction [24]. Complication rates have varied widely with the differing approaches with endoprosthetic/saddle replacement having the greatest range from 31% to 100% [10][11][12][13][14]29,30], allograft reconstruction 36-89% [24][25][26][27], autograft reconstruction using the native proximal femur 54% [17], arthrodesis 25% [24,28], and resection without reconstruction 35-50% [24,28,31].…”

“…In these cases, conventional total hip replacement alone will fail as the structurally deficient bone is not adequate for prevention of acetabular component migration or loosening. Several treatment options have been described in the literature including conventional hip arthroplasty, curettage, cementation, and acetabular reconstruction with pins, screws, acetabular reinforcement rings or allograft [3][4][5][6][7][8][9], iliofemoral (saddle) endoprostheses [10][11][12][13][14]; iliofemoral arthrodesis [15,16]; femoral autograft reconstruction [17]; and resection without reconstruction [18]. Most surgical interventions are primarily aimed at reconstructing the acetabulum by transmitting forces to stronger intact proximal pelvic bone [9].…”

Types of extended organ-sparing and reconstructive surgical interventions for tumor involvement of the cotyloid cavity

“…Все они характеризуются достаточно высокой частотой развития осложнений и неоднозначными функ-циональными результатами после операции. По мнению большинства специалистов, занимающихся реконструк-тивной онкохирургией тазового кольца, универсальной методики реконструкции параацетабулярной области при опухолевом поражении в настоящее время не существует [1,15,18,21,34,35,[47][48][49]. Анализ данных литературы свидетельствует об актуальности обсуждаемой проблемы и перспективности совершенствования имеющихся и разработки новых методик органосохраняющего лечения этих пациентов.…”