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Sarcoma
Volume 7, Issue 1, Pages 19-27
http://dx.doi.org/10.1080/1357714031000114174

Hand-Modelled Composite Prostheses after Resection of Peri-Acetabular Bone Malignancies

15 Impasse du Bon Pasteur, Rouen 76000, France
2Unité ďOncologie Pédiatrique-Adultes Jeunes, HôpitalAvicenne, 125 Rue de Stalingrad, Bobigny Cedex 93009, France
3University Hospital of Orthopaedics and Traumatology, 56 Nicolas Petkov Street, Sofia 16214, Bulgaria

Copyright © 2003 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose: To improve function after pelvic resection involving the acetabulum, using an anatomic composite implant built with screws and cement.

Material and method: Since 1990, 66 patients with peri-acetabular bone malignancies have been treated by extensive resection followed by hand-modelled innominate prosthesis with partially constrained total hip prosthesis. The hand-modelled innominate prosthesis was made of a titanium cup, a set of long titanium screws and two or three packs of gentamycine-loaded cement.

Results: Many postoperative complications were observed: deep infection (14%), hip prosthesis dislocation (25%) and local recurrence (15%). Sixteen patients (25%) had to be reoperated. Nevertheless, at last follow-up, 62 patients still had composite prosthesis. The mean functional result, rated according to a modified Enneking's staging system, was 80% with unlimited walking without support, average hip flexion 100°, length discrepancy less than 1 cm.

Discussion: These results were similar to those described in the literature for custom-made innominate prostheses and much better than those of alternative reconstructive procedures. Hand-modelled composite prostheses are cheaper, easier, more adaptable and enables better anchorage than custom-made prostheses. Such a procedure can be used even after total iliac wing resection.

Conclusion: The advantages of such a procedure plead for its extensive use after acetabular resection. But long-term follow-up is necessary to validate indications.