Reconstruction of periacetabular bone tumor by vascularized fibula graft and irradiated autograft.
BACKGROUND
Periacetabular reconstruction following malignant bone tumor resection for limb saving is extremely challenging. We attempted a new reconstruction method in two patients by combining a free vascularized fibula graft with an extracorporeally irradiated autograft.


METHODS
A 14-year-old boy with osteosarcoma and a 44-year-old man with chondrosarcoma were treated with wide excision of the tumor, followed by periacetabular reconstruction with an autogenous, extracorporeally irradiated osteoarticular graft combined with a free vascularized fibula graft.


RESULTS
Incorporation of the irradiated pelvic bone was achieved without any complications and the resulting limb function was good. Osteoarthritic changes were seen in one patient.


CONCLUSIONS
This reconstruction method was safe and reliable for primary, limb-sparing surgery. It is best indicated when the femoral head can be preserved and the mechanical strength of the affected acetabulum is maintained.
Muramatsu
Keiichi
K
Department of Orthopedic Surgery, Yamaguchi University School of Medicine, 1-1-1 Minami-Kogushi, Ube, Yamaguchi 755-8505, Japan. muramatu@yamaguchi-u.ac.jp
Ihara
Koichiro
K
Tani
Yasuhiro
Y
Iwanaga
Ryuta
R
Taguchi
Toshihiko
T
D000293:Adolescent; D001859:Bone Neoplasms / Q000098:blood supply / Q000473:pathology / Q000628:therapy*; D006801:Humans; D008297:Male; D009389:Neovascularization, Pathologic