Comparison of Pasteurized Autograft-Prosthesis Composite Reconstruction and Resection Hip Arthroplasty for Periacetabular Tumors

• Published in: Clinics in orthopedic surgery Vol. 9; no. 3; pp. 374 - 385
• Main Authors: Lee, Seung Yong, Jeon, Dae-Geun, Cho, Wan Hyeong, Song, Won Seok, Kong, Chang-Bae
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Orthopaedic Association 01-09-2017; 대한정형외과학회
• Subjects: Acetabulum - surgery; Adolescent; Adult; Aged; Arthroplasty, Replacement, Hip - methods; Autografts; Bone Neoplasms - surgery; Disinfection - methods; Female; Humans; Male; Middle Aged; Original; Prostheses and Implants; Reconstructive Surgical Procedures - methods; Young Adult; 정형외과학; Treatment outcome; Acetabulum; Reconstructive surgery
• ISSN: 2005-291X; 2005-4408
• DOI: 10.4055/cios.2017.9.3.374

Because of the high complication rate of anatomical reconstruction after periacetabular resection, the strategy of resection alone has been revisited. However, in terms of complications and functional outcome, whether resection hip arthroplasty (RHA) shows a superior result to that of pelvic ring reconstruction remains controversial.
We compared 24 RHAs and 16 pasteurized autograft-prosthesis composite (PPC) reconstructions regarding the complication rates, operative time, blood loss, and functional outcome.
Compared to 16 PPC hips, 24 RHA hips showed lower major and minor complication rates (
< 0.001), shorter surgical time (
< 0.001), and superior Musculoskeletal Tumor Society scores (
< 0.001). Of the 24 RHA hips, bony neo-acetabulum was identified in 7 on computed tomography and partial neo-acetabulum in 9; the remaining 8 had no bony acetabular structure. The average time to bony neo-acetabulum formation was 7 months (range, 4 to 13 months).
RHA for periacetabular tumors can be an excellent alternative to anatomical reconstruction. It offers short surgical time, low complication rates, and functional results comparable to those of other reconstruction methods. However, this procedure is indicated for patients who can accept some limb shortening, and a tumor should be confined to the periacetabular area.