The use of pasteurized autologous grafts for periacetabular reconstruction

Reconstruction after periacetabular resection is a challenge. We asked whether the use of pasteurized autologous grafts would provide satisfactory results regarding patient survival, local recurrence, and metastasis, and graft union and functional outcome. We retrospectively reviewed 11 patients having such grafts with a minimum followup of 12 months (mean, 40 months; range, 12-116 months). All patients underwent periacetabular (Type II) resection of malignant periacetabular tumors. The resected bone was treated in saline at 65 degrees C for 30 minutes and reimplanted into the host bone with internal fixation. Total hip arthroplasty was performed in all patients. Local recurrence occurred in two of nine patients with primary sarcoma. Ten grafts survived at the last followup. Union of the resected bone with the host bone was achieved in eight of the 11 patients at an average of 12 months. The overall functional rating was 61% according to the Musculoskeletal Tumor Society System, with better results in the patients with primary tumors. Graft fracture (one patient) and infection (one patient) were the major complications. Our data suggest the use of pasteurization may be a reasonable option for reconstruction after resection of malignant periacetabular tumors.

Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.