title: [Management of complications following resection and defect reconstruction of tumors near the hip joint].
abstract: BACKGROUND
  Tumorous destruction of the periacetabular region and the proximal femur are a consequence of either primary malignant bone tumor manifestation or metastatic disease, which is observed much more frequently and occurs typically in these skeletal segments. Pathological fractures of the proximal femur and periacetabular regions of the pelvis have a high incidence and ultimately lead to severe pain and immobilization.
  Advanced resection techniques and different types of defect reconstruction, allowing for oncologically sufficient resection of extensive tumors have contributed to a marked increase in the limb salvage rate. However, these procedures are associated with an increasing rate of several, sometimes severe intraoperative and postoperative complications.
  
  
  RESULTS
  Compared to elective total hip arthroplasty, the rate of postoperative deep infections, dislocations, the incidence of pathological and periprosthetic fractures and the prevalence of deep vein thrombosis are increased with high rates of postoperative mortality and local tumor recurrence, being the most serious complications. Pelvic involvement and subsequent periacetabular resection have the highest complication rate when compared to proximal femur resection with endoprosthetic treatment.
  
  
  CONCLUSIONS
  In order to minimize the risk of these intraoperative and postoperative complications wide resection and advanced reconstruction as well as complicated palliative stabilization due to malignant bone tumor growth around the hip joint should be performed in musculoskeletal tumor centers with profound expertise in osteosynthetic and endoprosthetic reconstruction of the pelvis and the proximal femur. Only in specialized centers an effective, multidisciplinary emergency management of these complications and, more importantly, reliable prevention of complications can be ensured.
authors.affiliation: Sektion für Muskuloskeletale Tumorchirurgie und Sektion für Wirbelsäulenchirurgie, Centrum für Muskuloskeletale Chirurgie, Charité-Universitätsmedizin Berlin, Campus Virchow-Klinikum und Campus Mitte, Augustenburger Platz 1, 13353, Berlin, Deutschland, klaus-dieter.schaser@charite.de.
authors.forename: K-D
authors.initials: KD
authors.lastname: Schaser
authors.forename: I
authors.initials: I
authors.lastname: Melcher
authors.forename: S
authors.initials: S
authors.lastname: Märdian
authors.forename: C
authors.initials: C
authors.lastname: Perka
authors.forename: R
authors.initials: R
authors.lastname: Locher
authors.forename: P
authors.initials: P
authors.lastname: Schwabe
mesh_terms: D005266:Femoral Neoplasms / Q000150:complications / Q000601:surgery*; D006617:Hip Dislocation / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control; D006620:Hip Fractures / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control; D006801:Humans; D007593:Joint Instability / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control; D016459:Prosthesis-Related Infections / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control; D019651:Plastic Surgery Procedures / Q000009:adverse effects*; D020246:Venous Thrombosis / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control