Long-term results of hemipelvis reconstruction with allografts

Thirteen patients underwent pelvic reconstruction by massive allografts aft er resection of a malignant tumor (primary in 10 patients and metastatic in three patients), In 10 patients, the tumor involved the acetabulum and ili ac wing and was reconstructed by a hemipelvic allograft; this was accompani ed by a hip arthroplasty in nine of the patients, In three patients, a femo ral metaphyseal tumor extending to the acetabulum was reconstructed by a to tal acetabular allograft and a composite proximal femoral allograft prosthe sis. Two patients (20%) had a local recurrence, and one patient died of mas sive pulmonary embolism. Postoperative complications were one infection and two dislocations. At 3 years, one cup loosening and one acetabular fatigue fracture required surgery, The functional result was excellent in two pati ents whose gluteal muscles could be spared, good (allowing a normal family life) in six patients, fair in two patients, and poor in two patients. Seve n patients had a Musculoskeletal Tumor Society rating greater than 60% of n ormal (the mean rating in 12 patients was 56,4%), No evidence of longterm d eterioration was seen in the patients with the longest followups (7, 8, 10, and 14 years). Reconstruction of the hemipelvis with massive allografts an d arthroplasty is a rewarding but demanding procedure and should be reserve d for physically active patients who are in good general health and are exp ected to have a response to anticancer therapy, The procedure is particular ly suitable for patients with primary tumors.