What are the 2-year survivorship outcomes of custom hemipelvis reconstruction after hemipelvectomy and revision arthroplasty? The evolution of a custom ilium "monoflange".

Autor: Hinckley NB; Mayo Clinic Arizona, Department of Orthopedic Surgery, Phoenix, Arizona, USA., Beauchamp CP; Mayo Clinic Arizona, Department of Orthopedic Surgery, Phoenix, Arizona, USA., Christopher ZK; Mayo Clinic Arizona, Department of Orthopedic Surgery, Phoenix, Arizona, USA., Schwartz AJ; Mayo Clinic Arizona, Department of Orthopedic Surgery, Phoenix, Arizona, USA., Ogunleye T; Burrell College of Osteopathic Medicine, Las Cruces, New Mexico, USA., Goulding KA; Mayo Clinic Arizona, Department of Orthopedic Surgery, Phoenix, Arizona, USA.
Jazyk: angličtina
Zdroj: Journal of surgical oncology [J Surg Oncol] 2023 Mar; Vol. 127 (3), pp. 480-489. Date of Electronic Publication: 2022 Oct 18.
DOI: 10.1002/jso.27124
Abstrakt: Background: Innovations in machined and three-dimensionally (3D) printed implant technology have allowed for customized complex pelvic reconstructions. We sought to determine the survivorship of custom hemipelvis reconstruction using ilium-only fixation at a minimum 2-year follow-up, their modes of failure, and the postoperative complications resulting from the procedure.
Methods: A retrospective review identified 12 consecutive patients treated with custom hemipelvis reconstruction. Indications for surgery were bone tumor requiring internal hemipelvectomy (four patients) or multiply revised, failed hip arthroplasty with massive bone loss (eight patients). All patients had a minimum of 2-year follow-up with a mean of 60.5 months. Kaplan-Meier survivorship analysis was determined for all patients. Postoperative complications and reoperations were categorized for all patients.
Results: At a mean of 60.5 months, 11 of 12 patients had retained their custom implant (92% survivorship). One implant was removed as a result of an acute periprosthetic joint infection (PJI). There were no cases of aseptic loosening. Seven of 12 patients required reoperation (three PJI; two dislocations; two superficial wound complications), with five patients going on to reoperation-free survival.
Conclusions: Custom hemipelvis reconstruction utilizing an ilium monoflange provides durable short-term fixation at a minimum 2-year follow-up. Reoperation for infection and dislocation is common.
(© 2022 Wiley Periodicals LLC.)
Databáze: MEDLINE
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