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The Harrington plus reconstruction for pelvic and acetabular metastases
Mukai Chimutengwende-Gordon1, Ross Coomber1, Fidel Peat1
1Cambridge Orthopaedic Pelvic Unit (COPU), Addenbrookes Major Trauma Centre, Cambridge University Hospitals NHS Foundation Trust, United Kingdom.
Background:
Surgical management of periacetabular bone metastases is challenging. The Harrington Plus reconstruction is a modification of the original Harrington rod technique. An intrapelvic suprapectineal plate is used, with the aim of reconstructing a disrupted anterior column and reducing the risk of failure in cases where there is extensive medial bone loss.
Methods:
A retrospective review of the 13 patients who have undergone the Harrington Plus procedure to date was performed. Mobility status, EQ5D and Oxford Hip scores were assessed.
Results:
There was a significant improvement in mobility status, EQ5D and Oxford Hip Scores at 6 months postoperatively (p < 0.05). Two patients returned to theatre for debridement of infection. There were no postoperative dislocations, cup medialisation or cases of loosening of the prosthesis. No patient required revision arthroplasty surgery.
Conclusion:
The Harrington Plus procedure produces a reliable construct that allows patients with extensive periacetabular metastatic defects to fully weight-bear. Careful patient selection and multidisciplinary management is essential.
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