Hand on composite prosthesis after resection of peri-acetabular sarcoma

Purpose of the study To improve function after pelvic resection involving theacetabulum we have used an anatomic composite implant built with screws and cement. Material and method Since 1990, 27 patients with peri-acetabular bone sarcoma have been treated by extensive resection followed by "hand on" innominate prosthesis with co nstrained total hip prosthesis. The hand on innominate prosthesis was made of a titanium cup, a set of long titanium screws and 2 or 3 packs of gentam ycin loaded ciment. Results Many postoperative complications were observed; deep infection (15 p. 100), hip prosthesis dislocation (33 p. 100) and local recurrence (17 p, 100). N ine patients (33 p. 100) had to be reoperated. Nevertheless at last follow up 24 patients still had their composite prosthesis. The mean functional re sult, rated according to a modified Enneking's staging system, was 83 p. 10 0 with unlimited walking without support, average hip flexion 100 degrees, length discrepancy less' than I centimeters. Discussion These results were similar to those described in the literature for custom made innominate prosthesis and much better than those of alternative recons tructive procedures. Hand on composite prosthesis is cheaper, easier, more adaptable and enables better anchorage than custom-made prosthesis. Such a procedure can be used even after total iliac wing resection. Conclusions The advantages of such procedure pleads for using it extensively after acet abular resection. But long term follow up is necessary to validate indicati ons.