title: Alloprosthetic composite is a suitable reconstruction after periacetabular tumor resection.
abstract: BACKGROUND
  Resection of a tumor of the pelvis is most disabling when the acetabulum is excised and a durable reconstruction of the defect is hard to achieve. All available methods are associated with frequent complications. Few large series have been published, and fewer have focused entirely on complete resections of the acetabulum. The use of an allograft-prosthetic composite allows customization on the operating table. However, while such composites restore anatomy and function of the pelvis the use of pelvic allografts is controversial and the durability is unknown.
  
  
  OBJECTIVE
  We therefore examined (1) the frequency of allograft and prosthetic failure, (2) positive and negative factors influencing the survival of the allograft prosthetic composite, and (3) function of patients with this reconstruction.
  
  
  METHODS
  We retrospectively evaluated 35 patients who had resection of the entire acetabulum and reconstruction with an allograft-prosthetic composite. Function was scored by the Musculoskeletal Tumor Society system. Followup in 24 survivors averaged 120 months (range, 61-188 months).
  
  
  RESULTS
  Greater than 75% of the allografts were still in place at last followup, and the original prosthetic reconstruction was still in place in 56%. Infection was an important negative factor for allograft survival. The average functional score was 72%, with better mean scores for patients who had reconstruction with a stemmed cup and an artificial ligament (average 89%).
  
  
  CONCLUSIONS
  An allograft-prosthetic composite provides a versatile substitution of the pelvis and hip, with functional scores approximately 75% of normal.
authors.affiliation: Orthopaedic Surgery, Department of Musculoskeletal Oncology, Istituto Ortopedico Rizzoli, Bologna, Italy.
authors.forename: Davide
authors.initials: D
authors.lastname: Donati
authors.forename: Claudia
authors.initials: C
authors.lastname: Di Bella
authors.forename: Tommaso
authors.initials: T
authors.lastname: Frisoni
authors.forename: Luca
authors.initials: L
authors.lastname: Cevolani
authors.forename: Henry
authors.initials: H
authors.lastname: DeGroot
mesh_terms: D000077:Acetabulum / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000295:instrumentation*; D001672:Biocompatible Materials; D001859:Bone Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D016025:Bone Transplantation / Q000009:adverse effects; D017024:Chemotherapy, Adjuvant; D005260:Female; D006085:Graft Survival; D006622:Hip Prosthesis / Q000009:adverse effects; D006801:Humans; D007558:Italy; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D010027:Osteotomy / Q000009:adverse effects; D016016:Proportional Hazards Models; D011474:Prosthesis Design; D011475:Prosthesis Failure; D016459:Prosthesis-Related Infections / Q000209:etiology; D011859:Radiography; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D001672:Biocompatible Materials