nach oben

International Orthopaedics

Erschienen in:

27.01.2018 | Original Paper

Pelvic reconstructions following peri-acetabular bone tumour resections using a cementless ice-cream cone prosthesis with dual mobility cup

verfasst von: Samir-Pierre Issa, David Biau, Antoine Babinet, Valérie Dumaine, Malo Le Hanneur, Philippe Anract

Erschienen in: International Orthopaedics | Ausgabe 8/2018

Einloggen, um Zugang zu erhalten

Abstract

Purpose

Despite numerous reconstructive techniques and prosthetic devices, pelvic reconstructions following peri-acetabular malignant tumours resections are highly challenging. In the present study, we describe our experience with the Integra® (Lépine, Genay, France) ice-cream cone prosthesis in such indications. The objective was to assess the mid-term outcomes of this device.

Methods

Twenty-four patients’ chart with peri-acetabular malignant tumours, who underwent types II or II + III peri-acetabular resections according to Enneking and Dunham with subsequent reconstruction using the Integra® prosthesis between February 2009 and February 2015, were reviewed. Seventeen cases were primary surgeries and seven cases were revisions (i.e., failures of previous reconstructions for pelvic tumours). All living patients with the prosthesis implanted were functionally assessed, using the musculoskeletal tumour society (MSTS) and Postel-Merle d’Aubigné (PMA) scores.

Results

After a mean follow-up of 49 ± 26 months (range, 8 to 94 months), 21 patients were alive (88%), including 15 patients continuously disease-free (63%). MSTS and PMA scores averaged 72 ± 13% (range, 43 to 87%) and 14.6 ± 2.6 (range, 9 to 18), respectively. Fourteen patients (58%) presented at least one complication during follow-up, including four cases of deep infection (17%), four cases of dislocation (17%), and two mechanical failures (8%). At 5 years, the implant survival rate was 75%.

Conclusions

In comparison to previous reconstructive techniques that we used in similar indications, functional and oncologic outcomes were improved with the Integra® implant. However, as commonly observed in pelvic bone tumour surgery, complication rates remain significant.

Level of evidence

Therapeutic, Level IV-Retrospective Cases Series

Price CH, Jeffree GM (1977) Incidence of bone sarcoma in SW England, 1946-74, in relation to age, sex, tumor site and histology. Br J Cancer 36:511–522CrossRefPubMedPubMedCentral

Steel HH (1978) Partial or complete resection of the hemipelvis: an alternative to hindquarter amputation for periacetabular chondrosarcoma of the pelvis. J Bone Joint Surg Am 60-A:719–730CrossRef

Enneking WF, Dunham WK (1978) Resection and reconstruction for primary neoplasms involving the innominate bone. J Bone Joint Surg Am 60:731–746CrossRefPubMed

Cottias P, Jeanrot C, Vinh TS, Tomeno B, Anract P (2001) Complications and functional evaluation of 17 saddle prostheses for resection of periacetabular tumors. J Surg Oncol 78:90–100CrossRefPubMed

Aljassir F, Beadel GP, Turcotte RE et al (2005) Outcome after pelvic sarcoma resection reconstructed with saddle prosthesis. Clin Orthop Relat Res 438:36–41CrossRefPubMed

Falkinstein Y, Ahlmann ER, Menendez LR (2008) Reconstruction of type II pelvic resection with a new peri-acetabular reconstruction endoprosthesis. J Bone Joint Surg Br 90:371–376. https://doi.org/10.1302/0301-620X.90B3.20144 CrossRefPubMed

Biau DJ, Thevenin F, Dumaine V, Babinet A, Thomeno B, Anract P (2009) Ipsilateral femoral auto-graft reconstruction after resection of a pelvic tumor. J Bone Joint Surg Am 91:142–151. https://doi.org/10.2106/JBJS.G.01061 CrossRefPubMed

Campanacci D, Chacon S, Mondanelli N et al (2012) Pelvic massive allograft reconstruction after bone tumour resection. Int Orthop 36:2529–2536. https://doi.org/10.1007/s00264-012-1677-4 CrossRefPubMedPubMedCentral

Witte D, Bernd L, Bruns J et al (2009) Limb-salvage reconstruction with MUTARS hemipelvic endoprosthesis: a prospective multicenter study. Eur J Surg Oncol 35:1318–1325. https://doi.org/10.1016/j.ejso.2009.04.011 CrossRefPubMed

10.

Zang W, Guo Y, Yang L, Xie L (2014) Reconstruction of the hemi-pelvis with a modular prosthesis after resection of a primary malignant peri-acetabular tumour involving the sacroiliac joint. Bone Joint J 96-B:399–405. https://doi.org/10.1302/0301-620X.96B3.32387 CrossRefPubMed

11.

Farfalli GL, Albergo JI, Ritacco LE, Ayerza MA, Musculo DL, Aponte-Tinao LA (2015) Oncologic and clinical outcomes in pelvic primary bone sarcomas treated with limb salvage surgery. Muscoloskelet Surg 99:237–242. https://doi.org/10.1007/s12306-015-0379-7 CrossRef

12.

Abudu A, Grimer RJ, Cannon SR, Sneath RS (1997) Reconstruction of the hemipelvis after the excision of malignant tumours. Complications and functional outcome of prostheses. J Bone Joint Surg Br 79:773–779CrossRefPubMed

13.

Angelini A, Calabro T, Pala E, Trovarelli G, Maraldi M, Ruggieri P (2015) Resection and reconstruction of pelvic bone tumors. Orthopedics 38:87–93. https://doi.org/10.3928/01477447-20150204-51 CrossRefPubMed

14.

Angelini A, Drago G, Trovarelli G, Calabro T, Ruggieri P (2014) Infection after surgical resection for pelvic bone tumors: an analysis of 270 patients from one institution. Clin Orthop Relat Res 472:349–359. https://doi.org/10.1007/s11999-013-3250-x CrossRefPubMed

15.

Desbonnet P, Connes H, Escare P, Tricoire JL, Trouillas J (2012) Total hip revision using a cup design with a peg to treat severe pelvic bone defects. Orthop Traumatol Surg Res 98:346–351. https://doi.org/10.1016/j.otsr.2012.01.006 CrossRefPubMed

16.

Enneking WF, Dunham W, Gebhardt MC, Malawar M, Pritchard DJ (1993) A system for the functional evaluation of reconstructive procedures after surgical treatment of tumors of the musculoskeletal system. Clin Orthop Relat Res 286:241–246

17.

D’Aubigné RM, Postel M (1954) Functional results of hip arthroplasty with acrylic prosthesis. J Bone Joint Surg Am 36-A:451–475CrossRefPubMed

18.

Kaplan EL, Meier P (1958) Nonparametric estimation from incomplete observations. J Am Stat Assoc 58:457–481CrossRef

19.

Wittekind C, Compton CC, Greene FL, Sobin LH (2002) TNM residual tumor classification revisited. Cancer 94:2511–2516. https://doi.org/10.1002/cncr.10492 CrossRefPubMed

20.

Fisher NE, Patton JT, Grimer RJ et al (2011) Ice-cream cone reconstruction of the pelvis: a new type of pelvic replacement: early results. J Bone Joint Surg Br 93:684–688. https://doi.org/10.1302/0301-620X.93B5.25608 CrossRefPubMed

21.

Barrientos-Ruiz I, Ortiz-Cruz EJ, Peleteiro-Pensado M (2017) Reconstruction after hemipelvectomy with the ice cream cone prosthesis: what are the short-term clinical results? Clin Orthop Relat Res 475:735–741. https://doi.org/10.1007/s11999-016-4747-x CrossRefPubMed

22.

Capanna R, van Horn JR, Guernelli N et al (1987) Complications of pelvic resections. Arch Orthop Trauma Surg 106:71–77CrossRefPubMed

23.

Bus MP, Boerhout EJ, Bramer JA, Dijkstra PD (2014) Clinical outcome of pedestal cup endoprosthetic reconstruction after resection of a peri-acetabular tumour. Bone Joint J 96-B:1706–1712. https://doi.org/10.1302/0301-620X.96B12.34622 CrossRefPubMed

24.

Jaiswal PK, Aston WJ, Grimer RJ et al (2008) Peri-acetabular resection and endoprosthetic reconstruction for tumours of the acetabulum. J Bone Joint Br 90:1222–1227. https://doi.org/10.1302/0301-620X.90B9.20758 CrossRef

25.

Bus MP, Szafranski A, Sellevold S et al (2017) LUMIC® endoprosthetic reconstruction after periacetabular tumor résection: short-term results. Clin Orthop Relat Res 475:686–695. https://doi.org/10.1007/s11999-016-4805-4 CrossRefPubMed

26.

Hipfl C, Stihsen C, Puchner SE et al (2017) Pelvic reconstruction following resection of malignant bone tumours using a stemmed acetabular pedestal cup. Bone Joint J 99-B:841–848. https://doi.org/10.1302/0301-620X.99B6.BJJ-2016-0944.R1 CrossRefPubMed

27.

Gebert C, Wessling M, Hoffmann C et al (2011) Hip transposition as a limb salvage procedure following the resection of periacetabular tumors. J Surg Oncol 103:269–275. https://doi.org/10.1002/jso.21820 CrossRefPubMed

28.

Jansen JA, van de Sande MAJ, Dijkstra PDS (2013) Poor long-term clinical results of saddle prosthesis after resection of periacetabular tumors. Clin Orthop Relat Res 471:324–331. https://doi.org/10.1007/s11999-012-2631-x CrossRefPubMed

29.

Puget J, Utheza G (1986) Reconstruction of the iliac bone using the homolateral femur after resection for pelvic tumor. Rev Chir Orthop Reparatrice Appar Mot 72:151–155 [Article in French]PubMed

30.

Puget J, Utheza G (2014) Reconstruction of the iliac bone using the homolateral femur after resection for pelvic tumor. Orthop Traumatol Surg Res 100:43–47. https://doi.org/10.1016/j.otsr.2013.12.007 CrossRefPubMed

31.

Testut L, Latarjet A (1928) Lower or pelvic limb osteology. In: Traité d’anatomie humaine, 1, 8e éd. Paris: Librairie Doin. 374–375 [Article in French]

32.

Ring PA (1968) Complete replacement arthroplasty of the hip by the ring prosthesis. J Bone Joint Surg Br 50-B:720–731CrossRef

33.

Tricoire JL, Puget J, Connes H, Canevet G, Moscovici J, Guitard J (2004) Anatomical study of the iliac isthmus, base of the acetabular fixation in large osseous defects in hip total arthroplasty revision cases. Morphologie 88:80 [Article in French]CrossRef

34.

Tricoire JL (2006) The acetabulum and its iliac isthmus: anatomy, anthropology and biomechanics. In: La reprise de prothèse totale de hanche. Montpellier: Sauramps médical. 171–179 [Article in French]

35.

Eisler T, Svensson O, Muren C, Elmstedt E (2001) Early loosening of the stemmed McMinn cup. J Arthroplast 16:871–876CrossRef

36.

Ferreira A, Prudhon JL, Verdier R et al (2017) Contemporary dual-mobility cup regional and private register: methodology and results. Int Orthop 41:439–445. https://doi.org/10.1007/s00264-017-3405-6 CrossRefPubMed

37.

Yi Z, Bin S, Jing Y, Zongke K, Fuxing P (2014) No decreased infection rate when using antibiotic-impregnated cement in primary total joint arthroplasty. Orthopedics 37:839–845. https://doi.org/10.3928/01477447-20141124-07 CrossRefPubMed

38.

Walker LC, Barker P, Holleyman R, Deehan D (2016) Microbial resistance related to antibiotic-loaded bone cement: a historical review. Knee Surg Sports Traumatol Arthrosc. https://doi.org/10.1007/s00167-016-4309-5

Titel: Pelvic reconstructions following peri-acetabular bone tumour resections using a cementless ice-cream cone prosthesis with dual mobility cup
verfasst von: Samir-Pierre Issa
David Biau
Antoine Babinet
Valérie Dumaine
Malo Le Hanneur
Philippe Anract
Publikationsdatum: 27.01.2018
Verlag: Springer Berlin Heidelberg
Erschienen in: International Orthopaedics / Ausgabe 8/2018
Print ISSN: 0341-2695
Elektronische ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-018-3785-2

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen.
» Jetzt entdecken

Neu im Fachgebiet Orthopädie und Unfallchirurgie

Knie-TEP: Kein Vorteil durch antibiotikahaltigen Knochenzement

29.05.2024 Periprothetische Infektionen Nachrichten

Zur Zementierung einer Knie-TEP wird in Deutschland zu über 98% Knochenzement verwendet, der mit einem Antibiotikum beladen ist. Ob er wirklich besser ist als Zement ohne Antibiotikum, kann laut Registerdaten bezweifelt werden.

Häusliche Gewalt in der orthopädischen Notaufnahme oft nicht erkannt

28.05.2024 Häusliche Gewalt Nachrichten

In der Notaufnahme wird die Chance, Opfer von häuslicher Gewalt zu identifizieren, von Orthopäden und Orthopädinnen offenbar zu wenig genutzt. Darauf deuten die Ergebnisse einer Fragebogenstudie an der Sahlgrenska-Universität in Schweden hin.

Fehlerkultur in der Medizin – Offenheit zählt!

28.05.2024 Fehlerkultur Podcast

Darüber reden und aus Fehlern lernen, sollte das Motto in der Medizin lauten. Und zwar nicht nur im Sinne der Patientensicherheit. Eine negative Fehlerkultur kann auch die Behandelnden ernsthaft krank machen, warnt Prof. Dr. Reinhard Strametz. Ein Plädoyer und ein Leitfaden für den offenen Umgang mit kritischen Ereignissen in Medizin und Pflege.

Mehr Frauen im OP – weniger postoperative Komplikationen

21.05.2024 Allgemeine Chirurgie Nachrichten

Ein Frauenanteil von mindestens einem Drittel im ärztlichen Op.-Team war in einer großen retrospektiven Studie aus Kanada mit einer signifikanten Reduktion der postoperativen Morbidität assoziiert.

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Springer Medizin

Pelvic reconstructions following peri-acetabular bone tumour resections using a cementless ice-cream cone prosthesis with dual mobility cup

Abstract

Purpose

Methods

Results

Conclusions

Level of evidence

Arthropedia

Neu im Fachgebiet Orthopädie und Unfallchirurgie

Knie-TEP: Kein Vorteil durch antibiotikahaltigen Knochenzement

Häusliche Gewalt in der orthopädischen Notaufnahme oft nicht erkannt

Fehlerkultur in der Medizin – Offenheit zählt!

Mehr Frauen im OP – weniger postoperative Komplikationen

Update Orthopädie und Unfallchirurgie

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Springer Medizin

Abstract

Purpose

Methods

Results

Conclusions

Level of evidence

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 8/2018

The status of triangular fibrocartilage complex after the union of distal radius fractures with internal plate fixation

Three-dimensional orientation and location-dependent varying rules of radiographic angles of the acetabular cup

Effectiveness of custom-made foot orthoses for treating forefoot pain: a systematic review

Successful initial experience with a novel outpatient total hip arthroplasty program in a public health system in Chile

A novel percutaneous achievement and maintenance of reduction and screw fixation for acute displaced scaphoid fractures: minimum two-year follow-up

Correction to : Hip osteonecrosis: stem cells for life or behead and arthroplasty?

Arthropedia

Neu im Fachgebiet Orthopädie und Unfallchirurgie

Knie-TEP: Kein Vorteil durch antibiotikahaltigen Knochenzement

Häusliche Gewalt in der orthopädischen Notaufnahme oft nicht erkannt

Fehlerkultur in der Medizin – Offenheit zählt!

Mehr Frauen im OP – weniger postoperative Komplikationen

Update Orthopädie und Unfallchirurgie