Major reconstruction for periacetabular metastasis: early complications and outcome following surgical treatment in 40 hips.
We performed 40 total hip arthroplasties with pelvic reconstruction in 37 patients with metastatic periacetabular tumor. 3 patients underwent bilateral periacetabular reconstructive surgery and 2 of these had bilateral procedures at the single operation. There were 8 Harrington class I, 7 class II, and 25 class III lesions. A modified Harrington procedure was employed. All patients showed improvements in hip pain, analgesic use, ambulation and mobility postoperatively. 1 prosthetic dislocation occurred after a fall at home 2 months following surgery. 2 patients had pulmonary emboli during the femoral procedure, 1 of whom died during surgery. There were no prosthetic loosenings. Preoperative CT and/or MRI are important for the study of metastatic involvement of acetabular bone. Durability of reconstruction requires appropriate use of acetabular mesh, Steinmann pins, acetabular reinforcement rings and long-stem femoral prostheses. Careful patient selection may improve quality of life. A sequential bilateral procedure should be considered for some patients.
Kunisada
T
T
Department of Orthopaedics, St Vincent's Hospital, Fitzroy, Victoria, Australia.
Choong
P F
PF
D000077:Acetabulum / Q000601:surgery*; D019644:Arthroplasty, Replacement, Hip / Q000379:methods; D001859:Bone Neoplasms / Q000556:secondary* / Q000601:surgery*; D001943:Breast Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology; D008297:Male; D009101:Multiple Myeloma / Q000473:pathology; D019637:Orthopedic Procedures; D011183:Postoperative Complications / Q000601:surgery*; D011471:Prostatic Neoplasms / Q000473:pathology*; D019651:Plastic Surgery Procedures; D012189:Retrospective Studies