[En bloc resection of the hip via a simultaneous double approach].
The pelvis is not an uncommon localization for primary or secondary tumors. Progress in chemotherapy has reduced the risk of metastasis and advances in reconstruction surgery using prostheses or allografts has made it possible to preserve a functional limb. We describe our method for en bloc resection of the hip. We use a double simultaneous approach for en bloc resection of the hip. The posterior Kocher-Langenbeck approach is associated with a anterior iliocrural approach. Each approach is performed by a separate team. We analyzed the advantages and disadvantages of this method, describing three recent cases. The double-simultaneous approach allowed greater safety for en bloc carcinological resection of the hip for patients with malignant tumors or aggressive intra-articular extension. Reconstruction was achieved with a total hip arthroplasty, reducing the duration of the operation and in theory, blood loss and risk of secondary infection. This method would not be indicated for patients without pelvic involvement nor for patients with a small-sized tumor (<5 cm).
Ghrea
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M
Service de Chirurgie Orthopédique et Traumatologique, Hôpital Saint-Antoine, 184, rue du Faubourg-Saint-Antoine, 75571 Paris Cedex 12, France.
Sautet
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Largab
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Apoil
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D000328:Adult; D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D001706:Biopsy; D016063:Blood Loss, Surgical / Q000517:prevention & control; D001859:Bone Neoplasms / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005684:Gait; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D010384:Pelvic Bones; D016059:Range of Motion, Articular; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000209:etiology / Q000517:prevention & control; D013997:Time Factors; D014057:Tomography, X-Ray Computed