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Megaprosthetic replacement of the pelvis: function in 17 cases
R J Wirbel1, M Schulte, B Maier
1Department of Trauma, University of Saarland, Homburg/Saar, Germany.
Acta Orthopaedica Scandinavica
|November 24, 1999
Summary
Pelvic megaprosthetic reconstruction effectively restored function in many patients with large bone defects, despite complications like infection and dislocation. Long-term survival depended on the underlying tumor.
Area of Science:
- Orthopedic Surgery
- Oncology
- Reconstructive Surgery
Background:
- Pelvic bone defects, often exceeding 10 cm, pose significant reconstructive challenges.
- Malignant bone and soft tissue tumors are the primary indication for extensive pelvic resections.
- Pelvic reconstruction with megaprostheses is a viable option for large bone defects.
Purpose of the Study:
- To evaluate the outcomes of megaprosthetic replacement for large pelvic bone defects.
- To assess the functional results and complication rates associated with pelvic megaprostheses.
- To analyze survival rates in patients undergoing pelvic reconstruction for oncologic indications.
Main Methods:
- A retrospective study of 39 patients treated between 1980 and 1997.
- Megaprosthetic replacement using polyacetal hemipelvic, CAD hemipelvic, or saddle prostheses.
- Clinical and radiographic follow-up with a mean of 58 months.
Main Results:
- 20 of 39 patients died due to their tumor.
- 10 local infections (2 requiring hemipelvectomy) and 6 hip dislocations occurred.
- 13 of 17 survivors achieved good or excellent functional results (MSTS), with 6 showing implant loosening.
Conclusions:
- Pelvic megaprosthetic reconstruction can achieve good functional outcomes in survivors.
- Complications such as infection and dislocation remain significant challenges.
- Tumor-related mortality is a major determinant of long-term survival in this patient cohort.