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Reconstruction using a constrained‐type hip tumor prosthesis after resection of malignant periacetabular tumors: A study by the Japanese Musculoskeletal Oncology Group (JMOG)
Author(s) -
Ogura Koichi,
Susa Michiro,
Morioka Hideo,
Matsumine Akihiko,
Ishii Takeshi,
Hamada Kenichiro,
Ueda Takafumi,
Kawai Akira
Publication year - 2018
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.25005
Subject(s) - medicine , surgery , prosthesis , amputation , soft tissue , complication , sarcoma , radiation therapy , pathology
Background We conducted a nationwide survey of prosthetic reconstruction using a constrained‐type hip tumor prosthesis (C‐THA) following resection of periacetabular tumors. Methods Eighty patients with periacetabular tumors underwent wide resection and prosthetic reconstruction using C‐THA at JMOG‐affiliated institutions (39 males and 41 females; mean age, 46.7 years; mean follow‐up period, 65 months). Primary bone or soft tissue sarcoma accounted for 75% of the cases. Adjuvant radiotherapy and chemotherapy were performed for 12 and 37 patients, respectively. Results There were 21 local recurrences (26%), necessitating amputation in 2 patients. Other postoperative complications included deep infection in 31 patients (39%), delayed wound healing in 25 (31%), and prosthesis‐related complications requiring surgery in 7 (9%). Removal of the prosthesis was required in 23 patients (29%) (deep infection ( n = 20), local recurrence resulting in amputation ( n = 2), and outer cup displacement ( n = 1). Patients whose abductor muscle was conserved or who underwent functional abductor muscle reconstruction showed significantly longer prosthesis survival. No postoperative wound complications occurred in three recent patients undergoing wound management with a RAM flap. The mean MSTS score was 43%. Conclusions We analyzed the outcome of 80 patients with periacetabular tumors undergoing C‐THA reconstruction. The rates of postoperative complication were still high, but comparable to those in previous studies. Our results suggest wound management using a RAM flap is useful for reducing wound complications.