How does iliosacral bone tumor resection without reconstruction affect the ipsilateral hip joint?

Area of Science:

• Orthopedic Oncology
• Surgical Outcomes
• Pelvic Reconstruction

Background:

• The benefit of reconstruction after iliosacral bone tumor resection is debated.
• High complication and recurrence rates limit the advantages of reconstruction.
• Assessing functional outcomes and hip joint changes after partial iliosacral resection is crucial.

Purpose of the Study:

• To evaluate functional outcomes after partial iliosacral resection.
• To analyze changes in the ipsilateral hip joint post-resection.
• To compare outcomes with and without reconstruction.

Main Methods:

• Retrospective analysis of 21 patients undergoing iliosacral resection (18 without reconstruction, 3 with).
• Functional assessment using Musculoskeletal Tumor Society (MSTS 1993) and Toronto Extremity Salvage Score (TESS).
• Radiographic evaluation of acetabular coverage (I-A distance, Acetabulum-head index, CE angle) and limb-length discrepancy.

Main Results:

• No significant difference in functional outcomes (MSTS 1993, TESS) between reconstruction groups.
• Resection >1/3 I-A distance significantly impacted Acetabulum-head index and CE angle.
• Larger defects (>1/3 I-A distance) resulted in significant limb-length discrepancy.

Conclusions:

• Iliosacral resection without reconstruction is a viable option for pelvic tumors.
• Resections exceeding one-third of the I-A distance negatively affect limb length and acetabular coverage.
• Functional outcomes remain favorable regardless of reconstruction in selected cases.