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Clinical Orthopaedics and Related Research®

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01-03-2013 | Symposium: Papers Presented at the 2011 ISOLS Meeting in Beijing, China

Constrained Total Hip Megaprosthesis for Primary Periacetabular Tumors

Authors: Takafumi Ueda, MD, PhD, Shigeki Kakunaga, MD, PhD, Satoshi Takenaka, MD, PhD, Nobuhito Araki, MD, PhD, Hideki Yoshikawa, MD, PhD

Published in: Clinical Orthopaedics and Related Research® | Issue 3/2013

Abstract

Background

Limb-salvage reconstruction for periacetabular malignant tumors is one of the most challenging problems in orthopaedic oncology. Reconstructive options include resection arthroplasty, endoprosthesis, allograft, recycled autobone graft, arthrodesis, and pseudarthrosis. However, no standard procedure exists because of rarity and clinical variability of the disease. We previously developed a megaprosthetic system with a constrained total hip mechanism (C-THA).

Questions/purposes

We evaluated (1) survival of patients and C-THA; (2) postoperative function; and (3) complications.

Methods

We retrospectively reviewed 25 patients with primary periacetabular tumors treated using C-THA between 1985 and 2009. There were 18 male and seven female patients with a median age of 44 years (range, 16–72 years). They included 11 chondrosarcomas, eight osteosarcomas, two giant cell tumors of bone (one locally aggressive benign, one malignant), and others in four. Surgical margin was wide in 18 patients, marginal in five, and intralesional in two. The minimum postoperative followup for survivors was 32 months (median, 163 months; range, 32–285 months).

Results

The 10-year overall survival rate of all patients was 47%. C-THA implants survived in 19 of 25 patients at last followup. Twenty-one patients acquired ambulatory activity. There were seven local recurrences, resulting in hemipelvectomy in one patient. Postoperative complications included deep infection in eight of the 25 patients, dislocation in four, and aseptic loosening in two, necessitating five revision surgeries and three implant removals.

Conclusions

Our observations suggest C-THA using an acetabular reconstruction cup is a useful reconstructive option after resection of periacetabular malignant tumors despite frequent postoperative complications.

Level of Evidence

Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

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Title: Constrained Total Hip Megaprosthesis for Primary Periacetabular Tumors
Authors: Takafumi Ueda, MD, PhD
Shigeki Kakunaga, MD, PhD
Satoshi Takenaka, MD, PhD
Nobuhito Araki, MD, PhD
Hideki Yoshikawa, MD, PhD
Publication date: 01-03-2013
Publisher: Springer-Verlag
Published in: Clinical Orthopaedics and Related Research® / Issue 3/2013
Print ISSN: 0009-921X
Electronic ISSN: 1528-1132
DOI: https://doi.org/10.1007/s11999-012-2625-8

2024 ASCO Annual Meeting

Springer Medicine

Constrained Total Hip Megaprosthesis for Primary Periacetabular Tumors

Abstract

Background

Questions/purposes

Methods

Results

Conclusions

Level of Evidence

2024 ASCO Annual Meeting

Springer Medicine

Abstract

Background

Questions/purposes

Methods

Results

Conclusions

Level of Evidence

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