Evaluation of methods of bone defect reconstruction after iliac tumor resections

Background. The goal of our research was to evaluate methods of reconstructing iliac bone defects in the authors' own clinical material. Material and methods. Between 2001 and 2004 we treated 16 patients: 10 women and 6 men, ranging in age from 32 to 72 years. The follow-up period was 6-40 months. Outcome was assessed according to clinical examination and radiographic evaluation of the pelvis. Results. All patients after operative treatment were mobilized while still in hospital, and were able to walk assisted by crutches with partial weight bearing. Six patients with metastatic disease died within 18 months after surgery. Tumor progression with subsequent reoperation occurred in 1 case. In the remaining cases no tumor progression was found, other than slight lysis in the PMMA/bone border area. In patients with combined internal fixation and PMMA, there was good stabilization of the filling. In cases treated for giant cell tumor, good bone reconstruction was found radiologically. The patients with acetabular defects, who were operated with a Ganz reinforcement ring, were able to walk with weight bearing on a single crutch. No infection was found in any case. Conclusions. In our patients with periacetabular defects of the hip following resection and PMMA filling, we found no mechanical complications diminishing lower limb function. In cases with acetabular lesions the method of choice is early and thorough surgical treatment with subsequent bone grafting, implantation of a Ganz reinforcement ring, and total hip replacement.