Koichi Ogura1, Michiro Susa2,3, Hideo Morioka2, Akihiko Matsumine4,5, Takeshi Ishii6, Kenichiro Hamada7, Takafumi Ueda8, Akira Kawai1. 1. Department of Musculoskeletal Oncology, National Cancer Center Hospital, Tokyo, Japan. 2. Department of Orthopaedic Surgery, Keio University, Tokyo, Japan. 3. Department of Orthopaedic Surgery, National Defense Medical College, Saitama, Japan. 4. Department of Orthopaedic Surgery, Mie University Hospital, Tsu, Japan. 5. Department of Orthopaedic Surgery, Fukui University, Fukui, Japan. 6. Department of Orthopaedic Surgery, Chiba Cancer Center, Chiba, Japan. 7. Department of Orthopaedic Surgery, Osaka University, Osaka, Japan. 8. Department of Orthopaedic Surgery, Osaka National Hospital, Osaka, Japan.
Abstract
BACKGROUND: We conducted a nationwide survey of prosthetic reconstruction using a constrained-type hip tumor prosthesis (C-THA) following resection of periacetabular tumors. METHODS: Eighty patients with periacetabular tumors underwent wide resection and prosthetic reconstruction using C-THA at JMOG-affiliated institutions (39 males and 41 females; mean age, 46.7 years; mean follow-up period, 65 months). Primary bone or soft tissue sarcoma accounted for 75% of the cases. Adjuvant radiotherapy and chemotherapy were performed for 12 and 37 patients, respectively. RESULTS: There were 21 local recurrences (26%), necessitating amputation in 2 patients. Other postoperative complications included deep infection in 31 patients (39%), delayed wound healing in 25 (31%), and prosthesis-related complications requiring surgery in 7 (9%). Removal of the prosthesis was required in 23 patients (29%) (deep infection (n = 20), local recurrence resulting in amputation (n = 2), and outer cup displacement (n = 1). Patients whose abductor muscle was conserved or who underwent functional abductor muscle reconstruction showed significantly longer prosthesis survival. No postoperative wound complications occurred in three recent patients undergoing wound management with a RAM flap. The mean MSTS score was 43%. CONCLUSIONS: We analyzed the outcome of 80 patients with periacetabular tumors undergoing C-THA reconstruction. The rates of postoperative complication were still high, but comparable to those in previous studies. Our results suggest wound management using a RAM flap is useful for reducing wound complications.
BACKGROUND: We conducted a nationwide survey of prosthetic reconstruction using a constrained-type hip tumor prosthesis (C-THA) following resection of periacetabular tumors. METHODS: Eighty patients with periacetabular tumors underwent wide resection and prosthetic reconstruction using C-THA at JMOG-affiliated institutions (39 males and 41 females; mean age, 46.7 years; mean follow-up period, 65 months). Primary bone or soft tissue sarcoma accounted for 75% of the cases. Adjuvant radiotherapy and chemotherapy were performed for 12 and 37 patients, respectively. RESULTS: There were 21 local recurrences (26%), necessitating amputation in 2 patients. Other postoperative complications included deep infection in 31 patients (39%), delayed wound healing in 25 (31%), and prosthesis-related complications requiring surgery in 7 (9%). Removal of the prosthesis was required in 23 patients (29%) (deep infection (n = 20), local recurrence resulting in amputation (n = 2), and outer cup displacement (n = 1). Patients whose abductor muscle was conserved or who underwent functional abductor muscle reconstruction showed significantly longer prosthesis survival. No postoperative wound complications occurred in three recent patients undergoing wound management with a RAM flap. The mean MSTS score was 43%. CONCLUSIONS: We analyzed the outcome of 80 patients with periacetabular tumors undergoing C-THA reconstruction. The rates of postoperative complication were still high, but comparable to those in previous studies. Our results suggest wound management using a RAM flap is useful for reducing wound complications.
Authors: Victor Housset; Philippe Anract; Antoine Babinet; Guillaume Auberger; David Biau Journal: World J Surg Oncol Date: 2022-05-28 Impact factor: 3.253
Authors: Jie Wang; Li Min; Minxun Lu; Yuqi Zhang; Yitian Wang; Yi Luo; Yong Zhou; Hong Duan; Chongqi Tu Journal: Clin Orthop Relat Res Date: 2020-11 Impact factor: 4.755