[Hand on composite prosthesis after resection of peri-acetabular sarcoma].
OBJECTIVE
To improve function after pelvic resection involving theacetabulum we have used an anatomic composite implant built with screws and cement.


METHODS
Since 1990, 27 patients with peri-acetabular bone sarcoma have been treated by extensive resection followed by "hand on innominate prosthesis with constrained total hip prosthesis. The hand on innominate prosthesis was made of a titanium cup, a set of long titanium screws and 2 or 3 packs of gentamycin loaded ciment.


RESULTS
Many postoperative complications were observed; deep infection (15 p. 100), hip prosthesis dislocation (33 p. 100) and local recurrence (17 p. 100). Nine patients (33 p. 100) had to be reoperated. Nevertheless at last follow up 24 patients still had their composite prosthesis. The mean functional result, rated according to a modified Enneking's staging system, was 83 p. 100 with unlimited walking without support, average hip flexion 100 degrees, length discrepancy less than 1 centimeters.


CONCLUSIONS
These results were similar to those described in the literature for custom made innominate prosthesis and much better than those of alternative reconstructive procedures. Hand on composite prosthesis is cheaper, easier, more adaptable and enables better anchorage than custom-made prosthesis. Such a procedure can be used even after total iliac wing resection.


CONCLUSIONS
The advantages of such procedure pleads for using it extensively after acetabular resection. But long term follow up is necessary to validate indications.
Delepine
F
F
Département d'Orthopédie-Traumatologie et Chirurgie Plastique, Hôpital Charles Nicolle, 76031 Rouen, France.
Delepine
G
G
Sokolov
T
T
Hernigou
P
P
Goutallier
D
D
D000077:Acetabulum / Q000000981:diagnostic imaging / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000368:Aged; D019644:Arthroplasty, Replacement, Hip; D001843:Bone Cements; D001859:Bone Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007085:Ilium / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging / Q000601:surgery; D012516:Osteosarcoma / Q000000981:diagnostic imaging / Q000601:surgery*; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D011474:Prosthesis Design; D011475:Prosthesis Failure; D011859:Radiography; D012086:Reoperation
D001843:Bone Cements