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Biological reconstruction following the resection of malignant bone tumors of the pelvis.

Traub F, Andreou D, Niethard M, Tiedke C, Werner M, Tunn PU - Sarcoma (2013)

Bottom Line: Two- and five-year disease-specific survival rates of all patients were 86.1% and 57.7%, respectively.The mean functional MSTS score was 16.5 (~55%) for all patients.Conclusion.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedic Oncology, Sarcoma Center Berlin-Brandenburg, HELIOS Klinikum Berlin-Buch, Schwanebecker Chaussee 50, 13125 Berlin, Germany.

ABSTRACT
Background. Surgical treatment of malignant pelvic bone tumors can be very challenging. The objective of this retrospective study was to evaluate the oncological as well as the clinical and functional outcome after limb salvage surgery and biological reconstruction. Methods. The files of 27 patients with malignant pelvic bone tumors, who underwent surgical resection at our department between 2000 and 2011, were retrospectively analyzed (9 Ewing's sarcoma, 8 chondrosarcoma, 4 osteosarcoma, 1 synovial sarcoma, 1 malignant fibrous histiocytoma, and 4 carcinoma metastases). Results. After internal hemipelvectomy reconstruction was performed by hip transposition (n = 16), using autologous nonvascularised fibular graft (n = 5) or autologous iliac crest bone graft (n = 2). In one patient a proximal femor prothetis and in three patients a total hip prosthesis was implanted at the time of resection. The median follow-up was 33 months. Two- and five-year disease-specific survival rates of all patients were 86.1% and 57.7%, respectively. The mean functional MSTS score was 16.5 (~55%) for all patients. Conclusion. On the basis of the oncological as well as the clinical and functional outcome, biological reconstruction after internal hemipelvectomy seems to be a reliable technique for treating patients with a malignant pelvic bone tumor.

No MeSH data available.


Related in: MedlinePlus

(a) Anteroposterior radiograph of the pelvis, showing a periacetabular chondrosarcoma on the left. (b) and (c) MRI of the pelvis, showing the destruction of the cortical bone and extraosseous tumor expansion. Notably is that the hip joint is not infiltrated. (d) Anteroposterior radiograph after P2 resection and hip transposition.
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fig3: (a) Anteroposterior radiograph of the pelvis, showing a periacetabular chondrosarcoma on the left. (b) and (c) MRI of the pelvis, showing the destruction of the cortical bone and extraosseous tumor expansion. Notably is that the hip joint is not infiltrated. (d) Anteroposterior radiograph after P2 resection and hip transposition.

Mentions: Sixteen patients had a hip transposition after a resection involving the acetabulum. This procedure was first described by Gebert et al. [13], the procedure involved moving the femoral head proximally to the lateral side of the sacrum or the underside of the resected ilium after resection of the acetabulum (Figure 3). The joint capsule was reconstructed with use of a polyethylene terephthalate mesh tube (Implantcast, Buxtehude, Germany), which was fixed to the pelvis with transosseous sutures and formed a pouch for the femoral head. Soft tissues were reattached to the tube. Five patients had a P1 resection and pelvic reconstruction stabilized with an autologous nonvascularized fibular graft, and in two patients an autologous iliac crest bone graft was used for the pelvic reconstruction after P1 resection (Figure 2). In one patient an endoprosthetic replacement of the hip was already done before the diagnosis of the pelvic tumor, and in three patients the resection of the femoral head was required to achieve wide surgical margins. In these three cases a femoral respectively a total hip prosthesis was implanted at the time of resection.


Biological reconstruction following the resection of malignant bone tumors of the pelvis.

Traub F, Andreou D, Niethard M, Tiedke C, Werner M, Tunn PU - Sarcoma (2013)

(a) Anteroposterior radiograph of the pelvis, showing a periacetabular chondrosarcoma on the left. (b) and (c) MRI of the pelvis, showing the destruction of the cortical bone and extraosseous tumor expansion. Notably is that the hip joint is not infiltrated. (d) Anteroposterior radiograph after P2 resection and hip transposition.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3649758&req=5

fig3: (a) Anteroposterior radiograph of the pelvis, showing a periacetabular chondrosarcoma on the left. (b) and (c) MRI of the pelvis, showing the destruction of the cortical bone and extraosseous tumor expansion. Notably is that the hip joint is not infiltrated. (d) Anteroposterior radiograph after P2 resection and hip transposition.
Mentions: Sixteen patients had a hip transposition after a resection involving the acetabulum. This procedure was first described by Gebert et al. [13], the procedure involved moving the femoral head proximally to the lateral side of the sacrum or the underside of the resected ilium after resection of the acetabulum (Figure 3). The joint capsule was reconstructed with use of a polyethylene terephthalate mesh tube (Implantcast, Buxtehude, Germany), which was fixed to the pelvis with transosseous sutures and formed a pouch for the femoral head. Soft tissues were reattached to the tube. Five patients had a P1 resection and pelvic reconstruction stabilized with an autologous nonvascularized fibular graft, and in two patients an autologous iliac crest bone graft was used for the pelvic reconstruction after P1 resection (Figure 2). In one patient an endoprosthetic replacement of the hip was already done before the diagnosis of the pelvic tumor, and in three patients the resection of the femoral head was required to achieve wide surgical margins. In these three cases a femoral respectively a total hip prosthesis was implanted at the time of resection.

Bottom Line: Two- and five-year disease-specific survival rates of all patients were 86.1% and 57.7%, respectively.The mean functional MSTS score was 16.5 (~55%) for all patients.Conclusion.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedic Oncology, Sarcoma Center Berlin-Brandenburg, HELIOS Klinikum Berlin-Buch, Schwanebecker Chaussee 50, 13125 Berlin, Germany.

ABSTRACT
Background. Surgical treatment of malignant pelvic bone tumors can be very challenging. The objective of this retrospective study was to evaluate the oncological as well as the clinical and functional outcome after limb salvage surgery and biological reconstruction. Methods. The files of 27 patients with malignant pelvic bone tumors, who underwent surgical resection at our department between 2000 and 2011, were retrospectively analyzed (9 Ewing's sarcoma, 8 chondrosarcoma, 4 osteosarcoma, 1 synovial sarcoma, 1 malignant fibrous histiocytoma, and 4 carcinoma metastases). Results. After internal hemipelvectomy reconstruction was performed by hip transposition (n = 16), using autologous nonvascularised fibular graft (n = 5) or autologous iliac crest bone graft (n = 2). In one patient a proximal femor prothetis and in three patients a total hip prosthesis was implanted at the time of resection. The median follow-up was 33 months. Two- and five-year disease-specific survival rates of all patients were 86.1% and 57.7%, respectively. The mean functional MSTS score was 16.5 (~55%) for all patients. Conclusion. On the basis of the oncological as well as the clinical and functional outcome, biological reconstruction after internal hemipelvectomy seems to be a reliable technique for treating patients with a malignant pelvic bone tumor.

No MeSH data available.


Related in: MedlinePlus