title: The use of extracorporeally irradiated autografts in pelvic reconstruction following tumour resection.
abstract: The aim of this study was to evaluate the functional and oncological outcome of extracorporeally irradiated autografts used to reconstruct the pelvis after a P1/2 internal hemipelvectomy. The study included 18 patients with a primary malignant bone tumour of the pelvis. There were 13 males and five females with a mean age of 24.8 years (8 to 62). Of these, seven had an osteogenic sarcoma, six a Ewing's sarcoma, and five a chondrosarcoma. At a mean follow-up of 51.6 months (4 to 185), nine patients had died with metastatic disease while nine were free from disease. Local recurrence occurred in three patients all of whom eventually died of their disease. Deep infection occurred in three patients and required removal of their graft in two while the third underwent a hindquarter amputation for extensive flap necrosis. The mean Musculoskeletal Tumor Society functional score of the 16 patients who could be followed-up for at least 12 months was 77% (50 to 90). Those 15 patients who completed the Toronto Extremity Salvage Score questionnaire had a mean score of 71% (53 to 85). Extracorporeal irradiation and re-implantation of bone is a valid method of reconstruction after an internal hemipelvectomy. It has an acceptable morbidity and a functional outcome that compares favourably with other available reconstructive techniques.
authors.affiliation: The Royal Orthopaedic Hospital NHS Trust, Bristol Road South, Northfield, Birmingham, West Midlands, B31 2AP, UK.
authors.forename: H
authors.initials: H
authors.lastname: Wafa
authors.affiliation: The Royal Orthopaedic Hospital NHS Trust, Bristol Road South, Northfield, Birmingham, West Midlands, B31 2AP, UK.
authors.forename: R J
authors.initials: RJ
authors.lastname: Grimer
authors.affiliation: The Royal Orthopaedic Hospital NHS Trust, Bristol Road South, Northfield, Birmingham, West Midlands, B31 2AP, UK.
authors.forename: L
authors.initials: L
authors.lastname: Jeys
authors.affiliation: The Royal Orthopaedic Hospital NHS Trust, Bristol Road South, Northfield, Birmingham, West Midlands, B31 2AP, UK.
authors.forename: A T
authors.initials: AT
authors.lastname: Abudu
authors.affiliation: The Royal Orthopaedic Hospital NHS Trust, Bristol Road South, Northfield, Birmingham, West Midlands, B31 2AP, UK.
authors.forename: S R
authors.initials: SR
authors.lastname: Carter
authors.affiliation: The Royal Orthopaedic Hospital NHS Trust, Bristol Road South, Northfield, Birmingham, West Midlands, B31 2AP, UK.
authors.forename: R M
authors.initials: RM
authors.lastname: Tillman
mesh_terms: D000293:Adolescent; D000328:Adult; D064592:Autografts / Q000528:radiation effects*; D016025:Bone Transplantation / Q000379:methods*; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006428:Hemipelvectomy; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010384:Pelvic Bones / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D010386:Pelvic Neoplasms / Q000175:diagnosis / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult
keywords: Bone Tumours; Irradiated autografts; Pelvic Reconstruction