Hand-modelled composite prostheses after resection of peri-acetabular bone malignancies

Area of Science:

• Orthopedic Surgery
• Oncology
• Biomaterials

Background:

• Pelvic resections involving the acetabulum present reconstructive challenges.
• Peri-acetabular bone malignancies require extensive surgical intervention.
• Functional restoration after such resections is crucial for patient mobility.

Purpose of the Study:

• To evaluate the efficacy of an anatomic composite implant for acetabular reconstruction.
• To improve functional outcomes following pelvic resection involving the acetabulum.
• To assess the use of a hand-modelled prosthesis with screws and cement.

Main Methods:

• Retrospective analysis of 66 patients with peri-acetabular bone malignancies treated since 1990.
• Extensive resection followed by reconstruction with a hand-modelled innominate prosthesis (titanium cup, screws, gentamicin-loaded cement).
• Evaluation of functional results using a modified Enneking's staging system.

Main Results:

• 62 out of 66 patients retained the composite prosthesis at follow-up.
• Mean functional result of 80% with unlimited walking and average hip flexion of 100 degrees.
• Postoperative complications included deep infection (14%), dislocation (25%), and local recurrence (15%), with 25% requiring reoperation.

Conclusions:

• Hand-modelled composite prostheses provide comparable or superior results to custom-made options.
• These prostheses are cost-effective, adaptable, and offer better anchorage.
• The procedure is suitable even after total iliac wing resection, though long-term follow-up is needed.