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Major reconstruction for periacetabular metastasis: early complications and outcome following surgical treatment in 40 hips.
Acta Orthopaedica Scandinavica 2000 December
We performed 40 total hip arthroplasties with pelvic reconstruction in 37 patients with metastatic periacetabular tumor. 3 patients underwent bilateral periacetabular reconstructive surgery and 2 of these had bilateral procedures at the single operation. There were 8 Harrington class I, 7 class II, and 25 class III lesions. A modified Harrington procedure was employed. All patients showed improvements in hip pain, analgesic use, ambulation and mobility postoperatively. 1 prosthetic dislocation occurred after a fall at home 2 months following surgery. 2 patients had pulmonary emboli during the femoral procedure, 1 of whom died during surgery. There were no prosthetic loosenings. Preoperative CT and/or MRI are important for the study of metastatic involvement of acetabular bone. Durability of reconstruction requires appropriate use of acetabular mesh, Steinmann pins, acetabular reinforcement rings and long-stem femoral prostheses. Careful patient selection may improve quality of life. A sequential bilateral procedure should be considered for some patients.
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