TY - JOUR
T1 - Pelvic reconstruction for severe periacetabular metastatic disease
AU - Vena, Vincent E.
AU - Hsu, James
AU - Rosier, Randy N.
AU - O'Keefe, Regis J.
PY - 1999
Y1 - 1999
N2 - The functional outcome of acetabular reconstruction in 21 patients with severe acetabular deficiency was examined. The surgical indications were pain, immobility, and loss of independence. Surgical reconstruction included curettage, placement of an acetabular roof ring with screws crossing the defect, cementation of the defect, and cemented hip arthroplasty. Although three patients died within the first month, the mean postoperative survival was 14.5 ± 4.0 months, with a 10.4 ± 3.0-month period of independent living. Statistically significant postoperative improvements were seen in pain and mobility scores. Using the Musculoskeletal Tumor Society score for the lower extremity, a mean postoperative score of 14.2 of a total 30 was calculated. Low scores were attributed to the patients' overall disease, including the requirement of continued narcotic pain control, occupational restriction, and the presence of Trendelenburg limp. Surgical complications occurred in six patients and included three early postoperative deaths, two related to poor preoperative pulmonary function; two dislocations, one related to a late infection; one femoral nerve palsy; and one foot drop. Although associated with a high complication rate, acetabular reconstruction for metastatic disease can lead to marked improvement in pain control, function, independence, and quality of life in carefully selected patients.
AB - The functional outcome of acetabular reconstruction in 21 patients with severe acetabular deficiency was examined. The surgical indications were pain, immobility, and loss of independence. Surgical reconstruction included curettage, placement of an acetabular roof ring with screws crossing the defect, cementation of the defect, and cemented hip arthroplasty. Although three patients died within the first month, the mean postoperative survival was 14.5 ± 4.0 months, with a 10.4 ± 3.0-month period of independent living. Statistically significant postoperative improvements were seen in pain and mobility scores. Using the Musculoskeletal Tumor Society score for the lower extremity, a mean postoperative score of 14.2 of a total 30 was calculated. Low scores were attributed to the patients' overall disease, including the requirement of continued narcotic pain control, occupational restriction, and the presence of Trendelenburg limp. Surgical complications occurred in six patients and included three early postoperative deaths, two related to poor preoperative pulmonary function; two dislocations, one related to a late infection; one femoral nerve palsy; and one foot drop. Although associated with a high complication rate, acetabular reconstruction for metastatic disease can lead to marked improvement in pain control, function, independence, and quality of life in carefully selected patients.
UR - http://www.scopus.com/inward/record.url?scp=0032934168&partnerID=8YFLogxK
U2 - 10.1097/00003086-199905000-00026
DO - 10.1097/00003086-199905000-00026
M3 - Article
C2 - 10335296
AN - SCOPUS:0032934168
SN - 0009-921X
VL - 362
SP - 171
EP - 180
JO - Clinical orthopaedics and related research
JF - Clinical orthopaedics and related research
ER -