ABSTRACT
BACKGROUND & OBJECTIVE: Malignant tumors around the pelvis and acetabulum locate deeply with complex anatomic structure, meanwhile, the resection area involves the weight-loading alignment. Therefore, tumor resection plus acetabular joint reconstruction is a complicated operation. This study was to summarize our experience of tumor resection plus prosthesis reconstruction of the acetabular joint for this disease. METHODS: Clinical data of 12 patients with malignant tumors around the pelvis and acetabulum, treated with tumor resection plus prosthesis reconstruction of the acetabular joint from 1995 to 2006, were reviewed. The characteristics of the operating for this disease were analyzed in terms of preoperative preparation, operating strategy, prosthesis design, operating procedure, acetabular reconstruction, and postoperative rehabilitation. RESULTS: The patients were followed for 8-86 months, with a median of 46 months. Of the 4 patients with tumor relapse, 2 osteosarcoma patients died of lung metastasis at 15 months and 22 months after operation; 1 chondrosarcoma patient relapsed locally at 26 months after operation and died at 38 months after operation; 1 giant cell tumor patient relapsed locally at 13 months after operation and was treated by clearance of focal lesion, and survived tumor-freely till the end of follow-up. The other 9 patients still survived tumor-freely till the end of follow-up. The 1-year survival rate was 75.0%; the 3-and 5-year survival rates were 33.3%; the 7-year survival rate was 25.0%. According to Harris scoring criteria after total hip replacement, 3 patients scored 60-69, 5 scored 70-79, and 4 scored 80-90 in limb function. CONCLUSIONS: Pelvic tumor resection and prosthesis reconstruction of the acetabular joint has the characteristics of difficulty and high-risk. For bone tumors with relatively low malignancy, this surgical treatment is an ideal option.
Subject(s)
Acetabulum/surgery , Arthroplasty, Replacement, Hip/methods , Bone Neoplasms/surgery , Chondrosarcoma/surgery , Hip Prosthesis , Adult , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Bone Neoplasms/drug therapy , Bone Neoplasms/pathology , Chondrosarcoma/drug therapy , Chondrosarcoma/pathology , Female , Follow-Up Studies , Humans , Lung Neoplasms/secondary , Male , Middle Aged , Neoplasm Recurrence, Local , Osteosarcoma/drug therapy , Osteosarcoma/secondary , Osteosarcoma/surgery , Pelvic Bones/surgery , Survival Rate , Young AdultABSTRACT
OBJECTIVE: To evaluate the clinical effect of periosteal autograft in repair of ankylosis of elbow joint. METHODS: From May 1985 to November 1999, 18 cases of elbow joints ankylosis (6 cases of osteo-ankylosis, 12 cases of fibroankylosis) were treated by repairing articular surface with periosteal autografting. Out of 18 cases, 13 were caused by old dislocation and fracture of elbow joints, 3 by late rheumatoid arthritis, and 2 by old total joint tuberculosis. In this surgical approach, periosteum from upper end of tibia was transplanted into articular surface after correction of the elbow joint from ankylosis deformity, and continuous passive or active movement of the operated joint was adopted with skeletal traction through olecranon of ulna for 4 weeks after operation. All of the cases were followed up for 1-9 years, 5.2 years on average, before clinical evaluation. RESULTS: The elbow joints in 11 cases were restored to normal, the joints in 4 cases obtained active movement in the range of 100 degrees-0 degree, and the joints in the other 3 cases could only have limited movement because of severe muscular atrophy. CONCLUSION: The articular surface in arthroplasty of elbow joint ankylosis could be effectively repaired by periosteal autograft, and the function of the joints could be obviously improved by continuous movement of the joints after operation with skeletal traction.
