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Published on: October 25, 2024
Should the Pelvic Ring Be Closed After Tumor Resection? A Systematic Review
Verena Dammerer1, Melanie Ardelt2,3,4, Johannes Neugebauer2,3,4
1Department of Orthopedics and Traumatology Hospital Scheibbs, Eisenwurzenstraße 26, 3270 Scheibbs, Austria.
Cancers
|June 12, 2026
Summary
Pelvic reconstruction after internal hemipelvectomy for bone tumors is controversial. While 3D-printed implants offer functional benefits, non-reconstructive strategies may yield better outcomes with lower complication rates, suggesting selective use of reconstruction.
Area of Science:
- Orthopedic oncology
- Surgical reconstruction
- Biomaterials and implants
Background:
- Primary malignant bone tumors of the pelvis are rare but challenging, often requiring internal hemipelvectomy.
- Pelvic reconstruction following these resections is debated due to complex anatomy and potential complications.
- This review examines reconstruction techniques, outcomes, and complications in pelvic resections for bone tumors.
Purpose of the Study:
- To evaluate the role and effectiveness of pelvic ring reconstruction after internal hemipelvectomy for primary malignant bone tumors.
- To compare outcomes and complication rates between reconstructive and non-reconstructive strategies.
- To identify factors influencing functional gains and morbidity associated with pelvic reconstruction.
Main Methods:
- A systematic literature review was conducted in June 2025, searching PubMed, MEDLINE, and Cochrane Library.
- Search terms included 'hemipelvectomy' and 'orthopedic', focusing on studies from the last five years.
- 14 studies were included after full-text assessment of 80 retrieved articles, with data extraction on patient characteristics, methods, and outcomes.
Main Results:
- Patient-specific 3D-printed implants and biological reconstructions showed functional improvements (e.g., Musculoskeletal Tumor Society score, pain reduction) and osseointegration.
- However, reconstructive techniques, including Type III and personalized implants, were associated with frequent wound and infectious complications.
- Level I evidence indicated higher complication rates with reconstruction, while non-reconstructive strategies (e.g., spinal instrumentation) offered early ambulation and lower morbidity when spinopelvic stability was maintained.
Conclusions:
- Routine pelvic ring reconstruction after internal hemipelvectomy is not consistently justified by current evidence.
- Patient-specific 3D-printed implants improve function but carry risks of wound and infectious complications.
- Non-reconstructive approaches may provide comparable functional outcomes with reduced morbidity, advocating for selective reconstruction and further prospective research.
