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[Hand on composite prosthesis after resection of peri-acetabular sarcoma]
F Delepine1, G Delepine, T Sokolov
1Département d'Orthopédie-Traumatologie et Chirurgie Plastique, Hôpital Charles Nicolle, 76031 Rouen, France.
Summary
This study evaluated a novel composite prosthesis for acetabular reconstruction after pelvic resection. The hand-on prosthesis demonstrated good functional outcomes, comparable to custom implants, making it a viable option for acetabular reconstruction.
Area of Science:
- Orthopedic Surgery
- Oncology
- Biomedical Engineering
Background:
- Pelvic resections involving the acetabulum present reconstructive challenges.
- Improving functional outcomes after such extensive surgeries is crucial for patient quality of life.
Purpose of the Study:
- To assess the efficacy of an anatomic composite implant for acetabular reconstruction post-pelvic resection.
- To evaluate functional results and complications associated with this reconstructive technique.
Main Methods:
- Retrospective analysis of 27 patients with peri-acetabular bone sarcoma treated with extensive resection and a "hand-on" innominate prosthesis.
- The prosthesis comprised a titanium cup, titanium screws, and gentamicin-loaded cement.
- Follow-up included functional assessment using a modified Enneking's staging system.
Main Results:
- Postoperative complications included deep infection (15%), hip dislocation (33%), and local recurrence (17%).
- Nine patients (33%) required reoperation.
- At follow-up, 24 patients retained their prosthesis with a mean functional score of 83%, unlimited walking, 100-degree hip flexion, and minimal leg length discrepancy.
Conclusions:
- The "hand-on" composite prosthesis offers functional results comparable to custom-made implants and superior to alternative procedures.
- This technique is cost-effective, adaptable, and provides better anchorage, suitable even after total iliac wing resection.
- Further long-term follow-up is recommended to validate its indications.