Types and evaluation of reconstruction approach for malignant pelvic tumors around acetabulum.

Objective To evaluate the functional outcome of malignant periacetabular tumors treated by en bloc resection and reconstructed with different limb-salvage procedures. Methods Seventy-two pa-tients with tumors around acetabular were treated surgically in People's Hospital of Peking University be-tween July 2000 and July 2007, including 42 males and 30 females with an average age of 41 years (range,16-78). 39 patients were diagnosed with chondrosarcoma, and 10 with osteosarcoma, 9 with giant cell tumorand 5 with Ewing sarcoma, etc. Type Ⅱ, Ⅰ + Ⅱ, Ⅱ + Ⅲ, Ⅰ - Ⅲ, Ⅰ -Ⅳ, Ⅱ + Ⅲ +Ⅴ pelvic resection were 4,16, 29, 7, 10 and 6, respectively. Of 72 patients, 50 were reconstructed with modular hemipelvic prosthesis,7 with saddle prosthesis, 8 with cauterized tumor bone implantation and 7 with proximal femur and pelvicbone fusion. Results Sixty-one patients were successfully followed up, and the average time was 3.5 years.Eleven patients (18%) had local relapse, 8 deep infection and 6 dislocation. The average ISOLS evaluationscore was 22 for 45 patients with modular pelvic prosthetic reconstruction, including excellent in 7, good in24, fair in 9 and poor in 5, respectively. Type Ⅱ and Ⅱ +Ⅲ pelvic resection with reconstruction was ratedexcellent or good, in contrasted to type Ⅳ was poor. The average ISOLS evaluation score for 5 saddle pros-thetic reconstruction, 5 recycled tumor bone reimplantation and 6 proximal femur and pelvic bone fusion was11, 17 and 14, respectively. Conclusion Among the 4 different reconstruction methods, the patients withmodular pelvic prosthetic reconstruction had best function results, and the saddle prosthetic reconstructionhad the worst. In terms of different types of pelvic resection with modular pelvic prosthetic reconstruction,type Ⅱ had the best functional result, followed by type Ⅱ + Ⅲ, Ⅰ + Ⅱ, Ⅰ - Ⅲ, Ⅱ + Ⅲ + Ⅴ, and type Ⅰ - Ⅳhad the worst. Key words: Acetabulum;  Bone neoplasms;  Surgical procedures, operative;  Prosthesis implantation