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Early Results of Acetabular Reconstruction After Wide Periacetabular Oncologic Resection.

Abstract Reliable acetabular fixation in total hip arthroplasty following periacetabular resections is challenging. Tantalum components have been successfully implemented for difficult revision arthroplasties, but, to our knowledge, have not been reported for acetabular reconstruction following oncologic periacetabular resection. The primary purpose of the current study was to determine the early clinical outcomes, complications, and radiographic findings for acetabular reconstruction after oncologic periacetabular resection. In addition, a novel classification scheme for primary periacetabular resections and reconstructions is presented.
PMID
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Authors

Mayor MeshTerms

Arthroplasty, Replacement, Hip

Keywords
Journal Title the journal of bone and joint surgery. american volume
Publication Year Start




PMID- 28145959
OWN - NLM
STAT- MEDLINE
DCOM- 20170410
LR  - 20170817
IS  - 1535-1386 (Electronic)
IS  - 0021-9355 (Linking)
VI  - 99
IP  - 3
DP  - 2017 Feb 1
TI  - Early Results of Acetabular Reconstruction After Wide Periacetabular Oncologic
      Resection.
PG  - e9
LID - 10.2106/JBJS.16.00803 [doi]
AB  - BACKGROUND: Reliable acetabular fixation in total hip arthroplasty following
      periacetabular resections is challenging. Tantalum components have been
      successfully implemented for difficult revision arthroplasties, but, to our
      knowledge, have not been reported for acetabular reconstruction following
      oncologic periacetabular resection. The primary purpose of the current study was 
      to determine the early clinical outcomes, complications, and radiographic
      findings for acetabular reconstruction after oncologic periacetabular resection. 
      In addition, a novel classification scheme for primary periacetabular resections 
      and reconstructions is presented. METHODS: We reviewed 10 consecutive patients
      treated with tantalum acetabular reconstruction following periacetabular
      resection. All patients had a primary acetabular malignancy including
      chondrosarcoma (n = 7) and osteosarcoma (n = 3). The cohort included 6 males
      (60%). The mean age was 54 years (range, 30 to 73 years). The mean follow-up was 
      59 months (range, 8 to 113 months). RESULTS: At the most recent follow-up, 9
      patients were alive and 1 had died of the respective disease. All patients
      obtained full ambulatory status with the use of gait aids. Postoperative
      complications included dislocation (n = 3), wound-healing disturbance (n = 1),
      and deep venous thrombosis (n = 1). Two patients underwent reoperations for
      recurrent dislocations. The mean postoperative Harris hip score was 75 points
      (range, 49 to 92 points). CONCLUSIONS: Preliminary results of tantalum
      reconstruction following periacetabular resections provide reasonable improvement
      in early clinical outcomes and stable fixation in situations with massive bone
      loss and compromised bone quality. As expected due to the lack of a functioning
      abductor mechanism from the wide oncologic resection, early dislocations remain a
      concern. As such, we now consider the primary use of increasing constraint, but
      it must be balanced with the often compromised host bone. LEVEL OF EVIDENCE:
      Therapeutic Level IV. See Instructions for Authors for a complete description of 
      levels of evidence.
FAU - Abdel, Matthew P
AU  - Abdel MP
AD  - 1Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota 2Department 
      of Orthopedic Surgery, Charite Universitatsmedizin Berlin, Berlin, Germany.
FAU - von Roth, Philipp
AU  - von Roth P
FAU - Perry, Kevin I
AU  - Perry KI
FAU - Rose, Peter S
AU  - Rose PS
FAU - Lewallen, David G
AU  - Lewallen DG
FAU - Sim, Franklin H
AU  - Sim FH
LA  - eng
PT  - Journal Article
PL  - United States
TA  - J Bone Joint Surg Am
JT  - The Journal of bone and joint surgery. American volume
JID - 0014030
RN  - 6424HBN274 (Tantalum)
SB  - AIM
SB  - IM
MH  - Acetabulum/*pathology/*surgery
MH  - Adult
MH  - Aged
MH  - *Arthroplasty, Replacement, Hip
MH  - Bone Neoplasms/*pathology/*surgery
MH  - Disability Evaluation
MH  - Female
MH  - Hip Prosthesis
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Postoperative Complications
MH  - Range of Motion, Articular
MH  - Tantalum
MH  - Treatment Outcome
EDAT- 2017/02/02 06:00
MHDA- 2017/04/11 06:00
CRDT- 2017/02/02 06:00
PHST- 2017/02/02 06:00 [entrez]
PHST- 2017/02/02 06:00 [pubmed]
PHST- 2017/04/11 06:00 [medline]
AID - 10.2106/JBJS.16.00803 [doi]
AID - 00004623-201702010-00012 [pii]
PST - ppublish
SO  - J Bone Joint Surg Am. 2017 Feb 1;99(3):e9. doi: 10.2106/JBJS.16.00803.