Skip to main content
Top
Published in: Clinical Orthopaedics and Related Research® 1/2014

01-01-2014 | Clinical Research

Infection After Surgical Resection for Pelvic Bone Tumors: An Analysis of 270 Patients From One Institution

Authors: Andrea Angelini, MD, Gabriele Drago, MD, Giulia Trovarelli, MD, Teresa Calabrò, MD, Pietro Ruggieri, MD, PhD

Published in: Clinical Orthopaedics and Related Research® | Issue 1/2014

Login to get access

Abstract

Background

Surgical treatment of pelvic tumors with or without acetabular involvement is challenging. Primary goals of surgery include local control and maintenance of good quality of life, but the procedures are marked by significant perioperative morbidity and complications.

Questions/purposes

We wished to (1) evaluate the frequency of infection after limb salvage surgical resection for bone tumors in the pelvis; (2) determine whether infection after these resections is associated with particular risk factors, including pelvic reconstruction, radiotherapy or chemotherapy, type of resection, and age; and (3) analyze treatment of these infections, particularly with respect to the need of additional surgery or hemipelvectomy.

Methods

From 1975 to 2010, 270 patients with pelvic bone tumors (149 with chondrosarcoma, 40 with Ewing’s sarcoma, 27 with osteosarcoma, 18 with other primary malignant tumors, 11 with metastatic tumors, and 25 with primary benign tumors) were treated by surgical resection. Minimum followup was 1.1 years (mean, 8 years; range, 1–33 years). The resection involved the periacetabular area in 166 patients. In 137 patients reconstruction was performed; in 133 there was no reconstruction. Chart review ascertained the frequency of deep infections, how they were treated, and the frequency of resection arthroplasty or hemipelvectomies that occurred thereafter.

Results

A total of 55 patients (20%) had a deep infection develop at a mean followup of 8 months. There were 20 infections in 133 patients without reconstruction (15%) and 35 infections in 137 patients with reconstruction (26 %). Survivorship rates of the index procedures using infection as the end point were 87%, 83%, and 80% at 1 month, 1 year, and 5 years, respectively. Infection was more common in patients who underwent pelvic reconstruction after resection (univariate analysis, p = 0.0326; multivariate analysis, p = 0.0418; odds ratio, 1.7718; 95% CI, 1.0243–3.0650); no other risk factors we evaluated were associated with an increased likelihood of infection. Despite surgical débridements and antibiotics, 16 patients (46%) had the implant removed and five (9%) underwent external hemipelvectomy (four owing to infection and one as a result of persistent infection and local recurrence).

Conclusions

Infection is a common complication of pelvic resection for bone tumors. Reconstruction after resection is associated with an increased risk of infection compared with resection alone, without significant difference in percentage between allograft and metallic prosthesis. When infection occurs, it requires removal of the implant in nearly half of the patients who have this complication develop, and external hemipelvectomy sometimes is needed to eradicate the infection.

Level of Evidence

Level IV, therapeutic study. See the Instructions for Authors for a complete description of levels of evidence.
Literature
1.
go back to reference Aboulafia AJ, Buch R, Mathews J, Li W, Malawer MM. Reconstruction using the saddle prosthesis following excision of primary and metastatic periacetabular tumors. Clin Orthop Relat Res. 1995;314:203–213.PubMed Aboulafia AJ, Buch R, Mathews J, Li W, Malawer MM. Reconstruction using the saddle prosthesis following excision of primary and metastatic periacetabular tumors. Clin Orthop Relat Res. 1995;314:203–213.PubMed
2.
go back to reference Aboulafia AJ, Malawer MM. Surgical management of pelvic and extremity osteosarcoma. Cancer. 1993;71(10 suppl):3358–3366.PubMedCrossRef Aboulafia AJ, Malawer MM. Surgical management of pelvic and extremity osteosarcoma. Cancer. 1993;71(10 suppl):3358–3366.PubMedCrossRef
3.
go back to reference Abudu A, Grimer RJ, Cannon SR, Carter SR, Sneath RS. Reconstruction of the hemipelvis after the excision of malignant tumours: complications and functional outcome of prostheses. J Bone Joint Surg Br. 1997;79:773–779.PubMedCrossRef Abudu A, Grimer RJ, Cannon SR, Carter SR, Sneath RS. Reconstruction of the hemipelvis after the excision of malignant tumours: complications and functional outcome of prostheses. J Bone Joint Surg Br. 1997;79:773–779.PubMedCrossRef
4.
go back to reference Aljassir F, Beadel GP, Turcotte RE, Griffin AM, Bell RS, Wunder JS, Isler MH. Outcome after pelvic sarcoma resection reconstructed with saddle prosthesis. Clin Orthop Relat Res. 2005;438:36–41.PubMedCrossRef Aljassir F, Beadel GP, Turcotte RE, Griffin AM, Bell RS, Wunder JS, Isler MH. Outcome after pelvic sarcoma resection reconstructed with saddle prosthesis. Clin Orthop Relat Res. 2005;438:36–41.PubMedCrossRef
5.
go back to reference Angelini A, Guerra G, Mavrogenis AF, Pala E, Picci P, Ruggieri P. Clinical outcome of central conventional chondrosarcoma. J Surg Oncol. 2012;106:929–937.PubMedCrossRef Angelini A, Guerra G, Mavrogenis AF, Pala E, Picci P, Ruggieri P. Clinical outcome of central conventional chondrosarcoma. J Surg Oncol. 2012;106:929–937.PubMedCrossRef
6.
go back to reference Beadel GP, McLaughlin CE, Wunder JS, Griffin AM, Ferguson PC, Bell RS. Outcome in two groups of patients with allograft-prosthetic reconstruction of pelvic tumor defects. Clin Orthop Relat Res. 2005;438:30–35.PubMedCrossRef Beadel GP, McLaughlin CE, Wunder JS, Griffin AM, Ferguson PC, Bell RS. Outcome in two groups of patients with allograft-prosthetic reconstruction of pelvic tumor defects. Clin Orthop Relat Res. 2005;438:30–35.PubMedCrossRef
7.
go back to reference Bell RS, Davis AM, Wunder JS, Buconjic T, McGoveran B, Gross AE. Allograft reconstruction of the acetabulum after resection of stage-IIB sarcoma: intermediate-term results. J Bone Joint Surg Am. 1997;79:1663–1674.PubMed Bell RS, Davis AM, Wunder JS, Buconjic T, McGoveran B, Gross AE. Allograft reconstruction of the acetabulum after resection of stage-IIB sarcoma: intermediate-term results. J Bone Joint Surg Am. 1997;79:1663–1674.PubMed
8.
go back to reference Biau D, Thévenin F, Dumaine V, Babinet A, Tomeno B, Anract P. Ipsilateral femoral autograft reconstruction after resection of a pelvic tumor. J Bone Joint Surg Am. 2009;91:142–151.PubMedCrossRef Biau D, Thévenin F, Dumaine V, Babinet A, Tomeno B, Anract P. Ipsilateral femoral autograft reconstruction after resection of a pelvic tumor. J Bone Joint Surg Am. 2009;91:142–151.PubMedCrossRef
9.
go back to reference Campanacci M, Capanna R. Pelvic resections: the Rizzoli Institute experience. Orthop Clin North Am. 1991;22:65–86.PubMed Campanacci M, Capanna R. Pelvic resections: the Rizzoli Institute experience. Orthop Clin North Am. 1991;22:65–86.PubMed
10.
go back to reference Capanna R, van Horn JR, Guernelli N, Briccoli A, Ruggieri P, Biagini R, Bettelli G, Campanacci M. Complications of pelvic resections. Arch Orthop Trauma Surg. 1987;106:71–77.PubMedCrossRef Capanna R, van Horn JR, Guernelli N, Briccoli A, Ruggieri P, Biagini R, Bettelli G, Campanacci M. Complications of pelvic resections. Arch Orthop Trauma Surg. 1987;106:71–77.PubMedCrossRef
11.
go back to reference Carter SR, Eastwood DM, Grimer RJ, Sneath RS. Hindquarter amputation for tumours of the musculoskeletal system. J Bone Joint Surg Br. 1990;72:490–493.PubMed Carter SR, Eastwood DM, Grimer RJ, Sneath RS. Hindquarter amputation for tumours of the musculoskeletal system. J Bone Joint Surg Br. 1990;72:490–493.PubMed
12.
go back to reference Cottias P, Jeanrot C, Vinh TS, Tomeno B, Anract P. Complications and functional evaluation of 17 saddle prostheses for resection of periacetabular tumors. J Surg Oncol. 2001;78:90–100.PubMedCrossRef Cottias P, Jeanrot C, Vinh TS, Tomeno B, Anract P. Complications and functional evaluation of 17 saddle prostheses for resection of periacetabular tumors. J Surg Oncol. 2001;78:90–100.PubMedCrossRef
13.
go back to reference Delloye C, Banse X, Brichard B, Docquier PL, Cornu O. Pelvic reconstruction with a structural pelvic allograft after resection of a malignant bone tumor. J Bone Joint Surg Am. 2007;89:579–587.PubMedCrossRef Delloye C, Banse X, Brichard B, Docquier PL, Cornu O. Pelvic reconstruction with a structural pelvic allograft after resection of a malignant bone tumor. J Bone Joint Surg Am. 2007;89:579–587.PubMedCrossRef
14.
go back to reference Donati D, Di Bella C, Frisoni T, Cevolani L, DeGroot H. Alloprosthetic composite is a suitable reconstruction after periacetabular tumor resection. Clin Orthop Relat Res. 2011;469:1450–1458.PubMedCentralPubMedCrossRef Donati D, Di Bella C, Frisoni T, Cevolani L, DeGroot H. Alloprosthetic composite is a suitable reconstruction after periacetabular tumor resection. Clin Orthop Relat Res. 2011;469:1450–1458.PubMedCentralPubMedCrossRef
15.
go back to reference Donati D, El Ghoneimy A, Bertoni F, Di Bella C, Mercuri M. Surgical treatment and outcome of conventional pelvic chondrosarcoma. J Bone Joint Surg Br. 2005;87:1527–1530.PubMedCrossRef Donati D, El Ghoneimy A, Bertoni F, Di Bella C, Mercuri M. Surgical treatment and outcome of conventional pelvic chondrosarcoma. J Bone Joint Surg Br. 2005;87:1527–1530.PubMedCrossRef
16.
go back to reference Enneking WF. Pelvis. In: Enneking WF, ed. Musculoskeletal Tumor Surgery. New York, NY: Churchill-Livingstone; 1983:483–490. Enneking WF. Pelvis. In: Enneking WF, ed. Musculoskeletal Tumor Surgery. New York, NY: Churchill-Livingstone; 1983:483–490.
17.
go back to reference Enneking WF, Dunham WK. Resection and reconstruction for primary neoplasms involving the innominate bone. J Bone Joint Surg Am. 1978;60:731–746.PubMed Enneking WF, Dunham WK. Resection and reconstruction for primary neoplasms involving the innominate bone. J Bone Joint Surg Am. 1978;60:731–746.PubMed
18.
go back to reference Gebert C, Wessling M, Hoffmann C, Roedl R, Winkelmann W, Gosheger G, Hardes J. Hip transposition as a limb salvage procedure following the resection of periacetabular tumors. J Surg Oncol. 2011;103:269–275.PubMedCrossRef Gebert C, Wessling M, Hoffmann C, Roedl R, Winkelmann W, Gosheger G, Hardes J. Hip transposition as a limb salvage procedure following the resection of periacetabular tumors. J Surg Oncol. 2011;103:269–275.PubMedCrossRef
19.
go back to reference Guo W, Li D, Tang X, Ji T. Surgical treatment of pelvic chondrosarcoma involving periacetabulum. J Surg Oncol. 2010;101:160–165.PubMed Guo W, Li D, Tang X, Ji T. Surgical treatment of pelvic chondrosarcoma involving periacetabulum. J Surg Oncol. 2010;101:160–165.PubMed
20.
go back to reference Guo W, Li D, Tang X, Yang Y, Ji T. Reconstruction with modular hemipelvic prostheses for periacetabular tumor. Clin Orthop Relat Res. 2007;461:180–188.PubMed Guo W, Li D, Tang X, Yang Y, Ji T. Reconstruction with modular hemipelvic prostheses for periacetabular tumor. Clin Orthop Relat Res. 2007;461:180–188.PubMed
21.
go back to reference Guo W, Sun X, Ji T, Tang X. Outcome of surgical treatment of pelvic osteosarcoma. J Surg Oncol. 2012;106:406–410.PubMedCrossRef Guo W, Sun X, Ji T, Tang X. Outcome of surgical treatment of pelvic osteosarcoma. J Surg Oncol. 2012;106:406–410.PubMedCrossRef
22.
go back to reference Guo Z, Li J, Pei GX, Li XD, Wang Z. Pelvic reconstruction with a combined hemipelvic prostheses after resection of primary malignant tumor. Surg Oncol. 2010;19:95–105.PubMedCrossRef Guo Z, Li J, Pei GX, Li XD, Wang Z. Pelvic reconstruction with a combined hemipelvic prostheses after resection of primary malignant tumor. Surg Oncol. 2010;19:95–105.PubMedCrossRef
23.
go back to reference Ham SJ, Schraffordt Koops H, Veth RP, van Horn JR, Eisma WH, Hoekstra HJ. External and internal hemipelvectomy for sarcomas of the pelvic girdle: consequences of limb-salvage treatment. Eur J Surg Oncol. 1997;23:540–546.PubMedCrossRef Ham SJ, Schraffordt Koops H, Veth RP, van Horn JR, Eisma WH, Hoekstra HJ. External and internal hemipelvectomy for sarcomas of the pelvic girdle: consequences of limb-salvage treatment. Eur J Surg Oncol. 1997;23:540–546.PubMedCrossRef
25.
go back to reference Harrington KD. The use of hemipelvic allografts or autoclaved grafts for reconstruction after wide resections of malignant tumors of the pelvis. J Bone Joint Surg Am. 1992;74:331–341.PubMed Harrington KD. The use of hemipelvic allografts or autoclaved grafts for reconstruction after wide resections of malignant tumors of the pelvis. J Bone Joint Surg Am. 1992;74:331–341.PubMed
26.
go back to reference Hillmann A, Hoffmann C, Gosheger G, Rodl R, Winkelmann W, Ozaki T. Tumors of the pelvis: complications after reconstruction. Arch Orthop Trauma Surg. 2003;123:340–344.PubMedCrossRef Hillmann A, Hoffmann C, Gosheger G, Rodl R, Winkelmann W, Ozaki T. Tumors of the pelvis: complications after reconstruction. Arch Orthop Trauma Surg. 2003;123:340–344.PubMedCrossRef
27.
go back to reference Jaiswal PK, Aston WJ, Grimer RJ, Abudu A, Carter S, Blunn G, Briggs TW, Cannon S. Peri-acetabular resection and endoprosthetic reconstruction for tumours of the acetabulum. J Bone Joint Surg Br. 2008;90:1222–1227.PubMedCrossRef Jaiswal PK, Aston WJ, Grimer RJ, Abudu A, Carter S, Blunn G, Briggs TW, Cannon S. Peri-acetabular resection and endoprosthetic reconstruction for tumours of the acetabulum. J Bone Joint Surg Br. 2008;90:1222–1227.PubMedCrossRef
28.
go back to reference Kaplan E, Meier P. Nonparametric estimation from incomplete observations. J Am Stat Assoc. 1958;53:457–481.CrossRef Kaplan E, Meier P. Nonparametric estimation from incomplete observations. J Am Stat Assoc. 1958;53:457–481.CrossRef
29.
go back to reference Laffosse JM, Pourcel A, Reina N, Tricoire JL, Bonnevialle P, Chiron P, Puget J. Primary tumor of the periacetabular region: resection and reconstruction using a segmental ipsilateral femur autograft. Orthop Traumatol Surg Res. 2012;98:309–318.PubMedCrossRef Laffosse JM, Pourcel A, Reina N, Tricoire JL, Bonnevialle P, Chiron P, Puget J. Primary tumor of the periacetabular region: resection and reconstruction using a segmental ipsilateral femur autograft. Orthop Traumatol Surg Res. 2012;98:309–318.PubMedCrossRef
30.
go back to reference Langlais F, Lambotte JC, Thomazeau H. Long-term results of hemipelvis reconstruction with allografts. Clin Orthop Relat Res. 2001;388:178–186.PubMedCrossRef Langlais F, Lambotte JC, Thomazeau H. Long-term results of hemipelvis reconstruction with allografts. Clin Orthop Relat Res. 2001;388:178–186.PubMedCrossRef
31.
go back to reference Mankin HJ, Doppelt S, Tomford W. Clinical experience with allograft implantation: the first ten years. Clin Orthop Relat Res. 1983;174:69–86.PubMed Mankin HJ, Doppelt S, Tomford W. Clinical experience with allograft implantation: the first ten years. Clin Orthop Relat Res. 1983;174:69–86.PubMed
32.
go back to reference Masterson EL, Davis AM, Wunder JS, Bell RS. Hindquarter amputation for pelvic tumors: the importance of patient selection. Clin Orthop Relat Res. 1998;350:187–194.PubMed Masterson EL, Davis AM, Wunder JS, Bell RS. Hindquarter amputation for pelvic tumors: the importance of patient selection. Clin Orthop Relat Res. 1998;350:187–194.PubMed
33.
go back to reference Mavrogenis AF, Soultanis K, Patapis P, Guerra G, Fabbri N, Ruggieri P, Papagelopoulos PJ. Pelvic resections. Orthopedics. 2012;35:e232–243.PubMedCrossRef Mavrogenis AF, Soultanis K, Patapis P, Guerra G, Fabbri N, Ruggieri P, Papagelopoulos PJ. Pelvic resections. Orthopedics. 2012;35:e232–243.PubMedCrossRef
34.
go back to reference Ozaki T, Hillmann A, Bettin D, Wuisman P, Winkelmann W. High complication rates with pelvic allografts: experience of 22 sarcoma resections. Acta Orthop Scand. 1996;67:333–338.PubMedCrossRef Ozaki T, Hillmann A, Bettin D, Wuisman P, Winkelmann W. High complication rates with pelvic allografts: experience of 22 sarcoma resections. Acta Orthop Scand. 1996;67:333–338.PubMedCrossRef
35.
go back to reference Ozaki T, Hillmann A, Lindner N, Blasius S, Winkelmann W. Chondrosarcoma of the pelvis. Clin Orthop Relat Res. 1997;337:226–239.PubMedCrossRef Ozaki T, Hillmann A, Lindner N, Blasius S, Winkelmann W. Chondrosarcoma of the pelvis. Clin Orthop Relat Res. 1997;337:226–239.PubMedCrossRef
36.
go back to reference Ozaki T, Hoffmann C, Hillmann A, Gosheger G, Lindner N, Winkelmann W. Implantation of hemipelvic prosthesis after resection of sarcoma. Clin Orthop Relat Res. 2002;396:197–205.PubMedCrossRef Ozaki T, Hoffmann C, Hillmann A, Gosheger G, Lindner N, Winkelmann W. Implantation of hemipelvic prosthesis after resection of sarcoma. Clin Orthop Relat Res. 2002;396:197–205.PubMedCrossRef
38.
go back to reference Puri A, Gulia A, Jambhekar NA, Laskar S. Results of surgical resection in pelvic Ewing’s sarcoma. J Surg Oncol. 2012;106:417–422.PubMedCrossRef Puri A, Gulia A, Jambhekar NA, Laskar S. Results of surgical resection in pelvic Ewing’s sarcoma. J Surg Oncol. 2012;106:417–422.PubMedCrossRef
39.
go back to reference Rodl RW, Hoffmann C, Gosheger G, Leidinger B, Jurgens H, Winkelmann W. Ewing’s sarcoma of the pelvis: combined surgery and radiotherapy treatment. J Surg Oncol. 2003;83:154–160.PubMedCrossRef Rodl RW, Hoffmann C, Gosheger G, Leidinger B, Jurgens H, Winkelmann W. Ewing’s sarcoma of the pelvis: combined surgery and radiotherapy treatment. J Surg Oncol. 2003;83:154–160.PubMedCrossRef
40.
go back to reference Satcher RL Jr, O’Donnell RJ, Johnston JO. Reconstruction of the pelvis after resection of tumors about the acetabulum. Clin Orthop Relat Res. 2003;409:209–217.CrossRef Satcher RL Jr, O’Donnell RJ, Johnston JO. Reconstruction of the pelvis after resection of tumors about the acetabulum. Clin Orthop Relat Res. 2003;409:209–217.CrossRef
41.
go back to reference Schwameis E, Dominkus M, Krepler P, Dorotka R, Lang S, Windhager R, Kotz R. Reconstruction of the pelvis after tumor resection in children and adolescents. Clin Orthop Relat Res. 2002;402:220–235.PubMedCrossRef Schwameis E, Dominkus M, Krepler P, Dorotka R, Lang S, Windhager R, Kotz R. Reconstruction of the pelvis after tumor resection in children and adolescents. Clin Orthop Relat Res. 2002;402:220–235.PubMedCrossRef
42.
go back to reference Senchenkov A, Moran SL, Petty PM, Knoetgen J 3rd, Clay RP, Bite U, Barnes SA, Sim FH. Predictors of complications and outcomes of external hemipelvectomy wounds: account of 160 consecutive cases. Ann Surg Oncol. 2008;15:355–363.PubMedCrossRef Senchenkov A, Moran SL, Petty PM, Knoetgen J 3rd, Clay RP, Bite U, Barnes SA, Sim FH. Predictors of complications and outcomes of external hemipelvectomy wounds: account of 160 consecutive cases. Ann Surg Oncol. 2008;15:355–363.PubMedCrossRef
43.
go back to reference Sheth DS, Yasko AW, Johnson ME, Ayala AG, Murray JA, Romsdahl MM. Chondrosarcoma of the pelvis: prognostic factors for 67 patients treated with definitive surgery. Cancer. 1996;78:745–750.PubMedCrossRef Sheth DS, Yasko AW, Johnson ME, Ayala AG, Murray JA, Romsdahl MM. Chondrosarcoma of the pelvis: prognostic factors for 67 patients treated with definitive surgery. Cancer. 1996;78:745–750.PubMedCrossRef
44.
go back to reference Shin K-H, Rougraff BT, Simon MA. Oncologic outcomes of primary bone sarcomas of the pelvis. Clin Orthop Relat Res. 1994;304:207–217.PubMed Shin K-H, Rougraff BT, Simon MA. Oncologic outcomes of primary bone sarcomas of the pelvis. Clin Orthop Relat Res. 1994;304:207–217.PubMed
45.
go back to reference Windhager R, Karner J, Kutschera HP, Polterauer P, Salzer-Kuntschik M, Kotz R. Limb salvage in periacetabular sarcomas: review of 21 consecutive cases. Clin Orthop Relat Res. 1996;331:265–276.PubMedCrossRef Windhager R, Karner J, Kutschera HP, Polterauer P, Salzer-Kuntschik M, Kotz R. Limb salvage in periacetabular sarcomas: review of 21 consecutive cases. Clin Orthop Relat Res. 1996;331:265–276.PubMedCrossRef
46.
go back to reference Wirbel RJ, Schulte M, Maier B, Mutschler WE. Megaprosthetic replacement of the pelvis: function in 17 cases. Acta Orthop Scand. 1999;70:348–352.PubMedCrossRef Wirbel RJ, Schulte M, Maier B, Mutschler WE. Megaprosthetic replacement of the pelvis: function in 17 cases. Acta Orthop Scand. 1999;70:348–352.PubMedCrossRef
47.
go back to reference Wirbel RJ, Schulte M, Mutschler WE. Surgical treatment of pelvic sarcomas: oncologic and functional outcome. Clin Orthop Relat Res. 2001;390:190–205.PubMedCrossRef Wirbel RJ, Schulte M, Mutschler WE. Surgical treatment of pelvic sarcomas: oncologic and functional outcome. Clin Orthop Relat Res. 2001;390:190–205.PubMedCrossRef
48.
go back to reference Yoshida Y, Osaka S, Mankin HJ. Hemipelvic allograft reconstruction after periacetabular bone tumor resection. J Orthop Sci. 2000;5:198–204.PubMedCrossRef Yoshida Y, Osaka S, Mankin HJ. Hemipelvic allograft reconstruction after periacetabular bone tumor resection. J Orthop Sci. 2000;5:198–204.PubMedCrossRef
49.
go back to reference Yuen A, Ek ET, Choong PF. Research: is resection of tumours involving pelvic ring justified? A review of 49 consecutive cases. Int Semin Surg Oncol. 2005;2:9.PubMedCentralPubMedCrossRef Yuen A, Ek ET, Choong PF. Research: is resection of tumours involving pelvic ring justified? A review of 49 consecutive cases. Int Semin Surg Oncol. 2005;2:9.PubMedCentralPubMedCrossRef
50.
go back to reference Zeifang F, Buchner M, Zahlten-Hinguranage A, Bernd L, Sabo D. Complications following operative treatment of primary malignant bone tumours in the pelvis. Eur J Surg Oncol. 2004;30:893–899.PubMed Zeifang F, Buchner M, Zahlten-Hinguranage A, Bernd L, Sabo D. Complications following operative treatment of primary malignant bone tumours in the pelvis. Eur J Surg Oncol. 2004;30:893–899.PubMed
Metadata
Title
Infection After Surgical Resection for Pelvic Bone Tumors: An Analysis of 270 Patients From One Institution
Authors
Andrea Angelini, MD
Gabriele Drago, MD
Giulia Trovarelli, MD
Teresa Calabrò, MD
Pietro Ruggieri, MD, PhD
Publication date
01-01-2014
Publisher
Springer US
Published in
Clinical Orthopaedics and Related Research® / Issue 1/2014
Print ISSN: 0009-921X
Electronic ISSN: 1528-1132
DOI
https://doi.org/10.1007/s11999-013-3250-x

Other articles of this Issue 1/2014

Clinical Orthopaedics and Related Research® 1/2014 Go to the issue