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Reconstruction of the hip after resection of periacetabular oncological lesions: a systematic review.

Abstract Reconstruction of the acetabulum after resection of a periacetabular malignancy is technically challenging and many different techniques have been used with varying success. Our aim was to prepare a systematic review of the literature dealing with these techniques in order to clarify the management, the rate of complications and the outcomes.
PMID
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Authors

Mayor MeshTerms
Keywords

Arthroplasty

Hip

Journal Title the bone & joint journal
Publication Year Start




PMID- 29292336
OWN - NLM
STAT- MEDLINE
DCOM- 20180104
LR  - 20180104
IS  - 2049-4408 (Electronic)
IS  - 2049-4394 (Linking)
VI  - 100-B
IP  - 1 Supple A
DP  - 2018 Jan
TI  - Reconstruction of the hip after resection of periacetabular oncological lesions: 
      a systematic review.
PG  - 22-30
LID - 10.1302/0301-620X.100B1.BJJ-2017-0548.R1 [doi]
AB  - AIMS: Reconstruction of the acetabulum after resection of a periacetabular
      malignancy is technically challenging and many different techniques have been
      used with varying success. Our aim was to prepare a systematic review of the
      literature dealing with these techniques in order to clarify the management, the 
      rate of complications and the outcomes. PATIENTS AND METHODS: A search of PubMed 
      and MEDLINE was conducted for English language articles published between January
      1990 and February 2017 with combinations of key search terms to identify studies 
      dealing with periacetabular resection with reconstruction in patients with a
      malignancy. Studies in English that reported radiographic or clinical outcomes
      were included. Data collected from each study included: the number and type of
      reconstructions, the pathological diagnosis of the lesions, the mean age and
      follow-up, gender distribution, implant survivorship, complications, functional
      outcome, and mortality. The results from individual studies were combined for the
      general analysis, and then grouped according to the type of reconstruction.
      RESULTS: A total of 57 studies met the inclusion criteria and included 1700
      patients. Most lesions were metastatic (41%), followed by chondrosarcoma (29%),
      osteosarcoma (10%), Ewing's sarcoma (7%), and multiple myeloma (2%). The
      techniques of reconstruction were divided into seven types for analysis: those
      involving a Harrington reconstruction, a saddle prosthesis, an allograft and
      allograft prosthesis composite, a pasteurised autograft, a porous tantalum
      implant, a custom-made prosthesis and a modular hemipelvic reconstruction. The
      rate of complications was 50%, with infection (14%) and instability (8%) being
      the most common. Mortality data were available for 1427 patients (84%); 50% had
      died of disease progression, 23% were alive with disease, and 27% had no evidence
      of disease at a mean follow-up of 3.4 years (0 to 34). CONCLUSION: Both the rate 
      of complications and mortality are high following resection of oncological
      periacetabular lesions and reconstruction. Many types of reconstruction have been
      used with unique challenges and complications for each technique. Newer
      prostheses, including custom-made prostheses and porous tantalum implants and
      augments, have shown promising early functional and radiographic outcomes. Cite
      this article: Bone Joint J 2018;100-B(1 Supple A):22-30.
CI  - (c)2018 The British Editorial Society of Bone & Joint Surgery.
FAU - Brown, T S
AU  - Brown TS
AD  - Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
FAU - Salib, C G
AU  - Salib CG
AD  - Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
FAU - Rose, P S
AU  - Rose PS
AD  - Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
FAU - Sim, F H
AU  - Sim FH
AD  - Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
FAU - Lewallen, D G
AU  - Lewallen DG
AD  - Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
FAU - Abdel, M P
AU  - Abdel MP
AD  - Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
LA  - eng
PT  - Journal Article
PT  - Review
PL  - England
TA  - Bone Joint J
JT  - The bone & joint journal
JID - 101599229
SB  - AIM
SB  - IM
MH  - Acetabulum/*surgery
MH  - Arthroplasty, Replacement, Hip/*methods/mortality
MH  - Bone Neoplasms/mortality/*surgery
MH  - Humans
MH  - Multiple Myeloma/mortality/*surgery
MH  - Postoperative Complications/epidemiology
MH  - Sarcoma/mortality/*surgery
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Arthroplasty
OT  - Hip
EDAT- 2018/01/03 06:00
MHDA- 2018/01/05 06:00
CRDT- 2018/01/03 06:00
PHST- 2017/05/05 00:00 [received]
PHST- 2017/06/07 00:00 [accepted]
PHST- 2018/01/03 06:00 [entrez]
PHST- 2018/01/03 06:00 [pubmed]
PHST- 2018/01/05 06:00 [medline]
AID - 100-B/1_Supple_A/22 [pii]
AID - 10.1302/0301-620X.100B1.BJJ-2017-0548.R1 [doi]
PST - ppublish
SO  - Bone Joint J. 2018 Jan;100-B(1 Supple A):22-30. doi:
      10.1302/0301-620X.100B1.BJJ-2017-0548.R1.