Partial replacement of pelvis with the hip joint in osteosarcoma treatment: A case report

Trung, Dung Tran; Quang, Sang Nguyen Tran; Trung, Hieu Pham; Tu, Nam Vu; Vo, Sy Quyen Nang; Duc, Thanh Tran; Dũng, Nguyên Tiến; Sơn, Trần Thiết; Dung, Phạm Thị Việt; Trưởng, Nguyễn Văn

doi:10.1016/j.amsu.2021.102812

Cited by 5 publications

(4 citation statements)

References 21 publications

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“…The T-SMART assessment in our study achieved a high success rate of 98.5% (128 out of 130 cases) for bone integration. (4) Theoretically, based on biomechanical research and early clinical follow-up evidence, complete reconstruction of the pelvic ring may contribute to a more balanced distribution of mechanical transmission and potentially enhance long-term prosthetic effectiveness [ 19 , 24 , 25 , 30 , 31 , 33 , 42 – 46 ]. From a biomechanical standpoint, the pelvic ring’s anatomy encompasses static (bony structures) and dynamic (ligaments, muscles, and tendons) stability.…”

Section: Discussionmentioning

confidence: 99%

3D-Printed custom-made hemipelvic endoprosthetic reconstruction following periacetabular tumor resection: utilizing a novel classification system

Hu,

Lu,

Wang

et al. 2024

BMC Musculoskelet Disord

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Background Customized 3D-printed pelvic implants with a porous structure have revolutionized periacetabular pelvic defect reconstruction after tumor resection, offering improved osteointegration, long-term stability, and anatomical fit. However, the lack of an established classification system hampers implementation and progress. Methods We formulated a novel classification system based on pelvic defect morphology and 3D-printed hemipelvis endoprostheses. It integrates surgical approach, osteotomy guide plate and prosthesis design, postoperative rehabilitation plans, and perioperative processes. Results Retrospectively analyzing 60 patients (31 males, 29 females), we classified them into Type A (15 patients: Aa = 6, Ab = 9), Type B (27 patients: Ba = 15, Bb = 12), Type C (17 patients). All underwent customized osteotomy guide plate-assisted tumor resection and 3D-printed hemipelvic endoprosthesis reconstruction. Follow-up duration was median 36.5 ± 15.0 months (range, 6 to 74 months). The mean operating time was 430.0 ± 106.7 min, intraoperative blood loss 2018.3 ± 1305.6 ml, transfusion volume 2510.0 ± 1778.1 ml. Complications occurred in 13 patients (21.7%), including poor wound healing (10.0%), deep prosthesis infection (6.7%), hip dislocation (3.3%), screw fracture (1.7%), and interface loosening (1.7%). VAS score improved from 5.5 ± 1.4 to 1.7 ± 1.3, MSTS-93 score from 14.8 ± 2.5 to 23.0 ± 5.6. Implant osseointegration success rate was 98.5% (128/130), with one Type Ba patient experiencing distal prosthesis loosening. Conclusion The West China classification may supplement the Enneking and Dunham classification, enhancing interdisciplinary communication and surgical outcomes. However, further validation and wider adoption are required to confirm clinical effectiveness.

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Section: Discussionmentioning

confidence: 99%

3D-Printed custom-made hemipelvic endoprosthetic reconstruction following periacetabular tumor resection: utilizing a novel classification system

Hu,

Lu,

Wang

et al. 2024

BMC Musculoskelet Disord

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“…Even if this minor complication happened, surgery was not required in most cases and a single incision drainage with primary closure could achieve successful healing. The adopted incision facilitated the preservation of the blood feeding of the femoral artery to the anterior flap and the superior gluteal artery to the posterior flap ( 45 ). Patients with type I + II + III resection were prone to incision complications due to the ligation of the invaded superior gluteal artery and subsequent receded perfusion of the lateral posterior flap.…”

Section: Discussionmentioning

confidence: 99%

Reconstruction of Tumor-Induced Pelvic Defects With Customized, Three-Dimensional Printed Prostheses

Shen

Peng

et al. 2022

Front. Oncol.

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BackgroundReconstruction of pelvis girdle stability after tumor-induced hemipelvectomy remains challenging. We surgically treated 13 patients with custom-made, three-dimensional printed hemipelvic prostheses. We aim to identify the preliminary outcomes for patients who have been managed with more mixed regions of prosthetic pelvic reconstruction and the feasibility of two reconstructive systems.MethodsSeven male patients and 6 female patients treated at our center between January 2019 and May 2021 were included. There were 11 primary sarcomas and 2 solitary bone metastases. After en bloc tumor resection, two types of personalized, three-dimensional printed prostheses were fixed to restore the stability and rebuild the load transfer. The position of the reconstructed hemipelvis was evaluated on an anteroposterior plain radiograph. The complications and outcomes were traced. One amputation specimen was discovered through histological analysis of the porous structure.ResultsThe operative duration was 467 ± 144 min, and the blood loss was 3,119 ± 662 ml. During a follow-up of 22.4 ± 8.5 months, two patients had delayed wound healing and one had a second-stage flap transfer. One patient with osteosarcoma died of pulmonary metastasis 27 months after surgery. Two patients with marginal resection suffered from local recurrence and had extra surgeries. One patient had traumatic hip dislocation 2 months after surgery and manipulative reduction was performed. The acetabular inclination of the affected side was 42.2 ± 4.3°, compared with 42.1 ± 3.9° on the contralateral side. The horizontal distance between the center of the femoral head and the middle vertical line was 10.4 ± 0.6 cm, while the reconstructed side was 9.8 ± 0.8 cm. No significant difference in acetabular position after surgery was found (p > 0.05). The amputation specimen harvested from one patient with local recurrence demonstrated bone and soft tissue ingrowth within the three-dimensional printed trabecular structure. Walking ability was preserved in all patients who are still alive and no prosthesis-related complications occurred. The MSTS score was 22.0 ± 3.7.ConclusionsBoth types of custom-made, three-dimensional printed prostheses manifested excellent precision, mechanical stability, and promising functional rehabilitation. The porous structure exhibited favorable histocompatibility to facilitate the ingrowth of bone and soft tissue.

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“…The "Mercedes-Benz" incision is a combination of the ilioinguinal and extended iliofemoral approaches. 28 The approach is so named as the The use of custom 3D computer-generated guides has been shown…”

Section: "Mercedes-benz" Incisionmentioning

confidence: 99%

“…The “Mercedes‐Benz” incision is a combination of the ilioinguinal and extended iliofemoral approaches 28 . The approach is so named as the incision is made trifurcate at approximately the mid‐point of the ilioinguinal portion.…”

Section: Surgical Approachesmentioning

confidence: 99%

Custom three‐dimensional printed implants for reconstruction of oncologic pelvic defects

Oyem,

Burke,

Mesko

et al. 2023

Journal of Surgical Oncology

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Partial replacement of pelvis with the hip joint in osteosarcoma treatment: A case report

Cited by 5 publications

References 21 publications

3D-Printed custom-made hemipelvic endoprosthetic reconstruction following periacetabular tumor resection: utilizing a novel classification system

3D-Printed custom-made hemipelvic endoprosthetic reconstruction following periacetabular tumor resection: utilizing a novel classification system

Reconstruction of Tumor-Induced Pelvic Defects With Customized, Three-Dimensional Printed Prostheses

Custom three‐dimensional printed implants for reconstruction of oncologic pelvic defects

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