Customised osteotomy guides and endoprosthetic reconstruction for periacetabular tumours
Identifieur interne : 002B99 ( Main/Curation ); précédent : 002B98; suivant : 002C00Customised osteotomy guides and endoprosthetic reconstruction for periacetabular tumours
Auteurs : Boris Michael Holzapfel [Allemagne] ; Hakan Pilge [Allemagne] ; Peter Michael Prodinger [Allemagne] ; Andreas Toepfer [Allemagne] ; Susanne Mayer-Wagner [Allemagne] ; Dietmar Werner Hutmacher [Allemagne] ; Ruediger Von Eisenhart-Rothe [Allemagne] ; Maximilian Rudert [Allemagne] ; Reiner Gradinger [Allemagne] ; Hans Rechl [Allemagne]Source :
- International Orthopaedics [ 0341-2695 ] ; 2014.
Abstract
We sought to analyse clinical and oncological outcomes of patients after guided resection of periacetabular tumours and endoprosthetic reconstruction of the remaining defect.
From 1988 to 2008, we treated 56 consecutive patients (mean age 52.5 years, 41.1 % women). Patients were followed up either until death or February 2011 (mean follow up 5.5 years, range 0.1–22.5, standard deviation ± 5.3). Kaplan–Meier analysis was used to estimate survival rates.
Disease-specific survival was 59.9 % at five years and 49.7 % at ten and 20 years, respectively. Wide resection margins were achieved in 38 patients, whereas 11 patients underwent marginal and seven intralesional resection. Survival was significantly better in patients with wide or marginal resection than in patients with intralesional resection (
The surgical approach assessed in this study simplifies the process of tumour resection and prosthesis implantation and leads to acceptable clinical and oncological outcomes.
Url:
DOI: 10.1007/s00264-014-2314-1
PubMed: 24658873
PubMed Central: 4071499
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Boris Michael Holzapfel<affiliation><nlm:aff id="Aff2">Regenerative Medicine, Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, Brisbane, QLD 4059 Australia</nlm:aff>
<wicri:noCountry code="subfield">QLD 4059 Australia</wicri:noCountry>
</affiliation>
<affiliation><nlm:aff id="Aff2">Regenerative Medicine, Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, Brisbane, QLD 4059 Australia</nlm:aff>
<wicri:noCountry code="subfield">QLD 4059 Australia</wicri:noCountry>
</affiliation>
<affiliation wicri:level="1"><nlm:aff id="Aff6">Institute for Advanced Study, Technical University Munich, Lichtenberg Str. 2a, Garching, 85748 Germany</nlm:aff>
<country xml:lang="fr">Allemagne</country>
<wicri:regionArea>Institute for Advanced Study, Technical University Munich, Lichtenberg Str. 2a, Garching</wicri:regionArea>
<wicri:noRegion>Garching</wicri:noRegion>
<wicri:noRegion>Garching</wicri:noRegion>
<wicri:noRegion>Garching</wicri:noRegion>
</affiliation>
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Customised osteotomy guides and endoprosthetic reconstruction for periacetabular tumours</title>
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<author><name sortKey="Pilge, Hakan" sort="Pilge, Hakan" uniqKey="Pilge H" first="Hakan" last="Pilge">Hakan Pilge</name>
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<country xml:lang="fr">Allemagne</country>
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<author><name sortKey="Prodinger, Peter Michael" sort="Prodinger, Peter Michael" uniqKey="Prodinger P" first="Peter Michael" last="Prodinger">Peter Michael Prodinger</name>
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<country xml:lang="fr">Allemagne</country>
<wicri:regionArea>Department of Orthopedics and Orthopedic Sports Medicine, Technical University Munich, Klinikum Rechts der Isar, Ismaninger Str. 22, Munich</wicri:regionArea>
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<region type="district" nuts="2">District de Haute-Bavière</region>
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<author><name sortKey="Toepfer, Andreas" sort="Toepfer, Andreas" uniqKey="Toepfer A" first="Andreas" last="Toepfer">Andreas Toepfer</name>
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<country xml:lang="fr">Allemagne</country>
<wicri:regionArea>Department of Orthopedics and Orthopedic Sports Medicine, Technical University Munich, Klinikum Rechts der Isar, Ismaninger Str. 22, Munich</wicri:regionArea>
<placeName><region type="land" nuts="1">Bavière</region>
<region type="district" nuts="2">District de Haute-Bavière</region>
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<author><name sortKey="Mayer Wagner, Susanne" sort="Mayer Wagner, Susanne" uniqKey="Mayer Wagner S" first="Susanne" last="Mayer-Wagner">Susanne Mayer-Wagner</name>
<affiliation wicri:level="3"><nlm:aff id="Aff5">Department of Orthopedic Surgery, Campus Grosshadern, Ludwig-Maximilians-University Munich, Marchioninistr. 15, Munich, 81377 Germany</nlm:aff>
<country xml:lang="fr">Allemagne</country>
<wicri:regionArea>Department of Orthopedic Surgery, Campus Grosshadern, Ludwig-Maximilians-University Munich, Marchioninistr. 15, Munich</wicri:regionArea>
<placeName><region type="land" nuts="1">Bavière</region>
<region type="district" nuts="2">District de Haute-Bavière</region>
<settlement type="city">Munich</settlement>
</placeName>
</affiliation>
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<author><name sortKey="Hutmacher, Dietmar Werner" sort="Hutmacher, Dietmar Werner" uniqKey="Hutmacher D" first="Dietmar Werner" last="Hutmacher">Dietmar Werner Hutmacher</name>
<affiliation><nlm:aff id="Aff2">Regenerative Medicine, Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, Brisbane, QLD 4059 Australia</nlm:aff>
<wicri:noCountry code="subfield">QLD 4059 Australia</wicri:noCountry>
</affiliation>
<affiliation wicri:level="1"><nlm:aff id="Aff6">Institute for Advanced Study, Technical University Munich, Lichtenberg Str. 2a, Garching, 85748 Germany</nlm:aff>
<country xml:lang="fr">Allemagne</country>
<wicri:regionArea>Institute for Advanced Study, Technical University Munich, Lichtenberg Str. 2a, Garching</wicri:regionArea>
<wicri:noRegion>Garching</wicri:noRegion>
<wicri:noRegion>Garching</wicri:noRegion>
<wicri:noRegion>Garching</wicri:noRegion>
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<author><name sortKey="Von Eisenhart Rothe, Ruediger" sort="Von Eisenhart Rothe, Ruediger" uniqKey="Von Eisenhart Rothe R" first="Ruediger" last="Von Eisenhart-Rothe">Ruediger Von Eisenhart-Rothe</name>
<affiliation wicri:level="3"><nlm:aff id="Aff3">Department of Orthopedics and Orthopedic Sports Medicine, Technical University Munich, Klinikum Rechts der Isar, Ismaninger Str. 22, Munich, 81675 Germany</nlm:aff>
<country xml:lang="fr">Allemagne</country>
<wicri:regionArea>Department of Orthopedics and Orthopedic Sports Medicine, Technical University Munich, Klinikum Rechts der Isar, Ismaninger Str. 22, Munich</wicri:regionArea>
<placeName><region type="land" nuts="1">Bavière</region>
<region type="district" nuts="2">District de Haute-Bavière</region>
<settlement type="city">Munich</settlement>
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<author><name sortKey="Rudert, Maximilian" sort="Rudert, Maximilian" uniqKey="Rudert M" first="Maximilian" last="Rudert">Maximilian Rudert</name>
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<country xml:lang="fr">Allemagne</country>
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<wicri:noRegion>Wuerzburg</wicri:noRegion>
<wicri:noRegion>Wuerzburg</wicri:noRegion>
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<author><name sortKey="Gradinger, Reiner" sort="Gradinger, Reiner" uniqKey="Gradinger R" first="Reiner" last="Gradinger">Reiner Gradinger</name>
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<country xml:lang="fr">Allemagne</country>
<wicri:regionArea>Department of Orthopedics and Orthopedic Sports Medicine, Technical University Munich, Klinikum Rechts der Isar, Ismaninger Str. 22, Munich</wicri:regionArea>
<placeName><region type="land" nuts="1">Bavière</region>
<region type="district" nuts="2">District de Haute-Bavière</region>
<settlement type="city">Munich</settlement>
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<author><name sortKey="Rechl, Hans" sort="Rechl, Hans" uniqKey="Rechl H" first="Hans" last="Rechl">Hans Rechl</name>
<affiliation wicri:level="3"><nlm:aff id="Aff3">Department of Orthopedics and Orthopedic Sports Medicine, Technical University Munich, Klinikum Rechts der Isar, Ismaninger Str. 22, Munich, 81675 Germany</nlm:aff>
<country xml:lang="fr">Allemagne</country>
<wicri:regionArea>Department of Orthopedics and Orthopedic Sports Medicine, Technical University Munich, Klinikum Rechts der Isar, Ismaninger Str. 22, Munich</wicri:regionArea>
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<region type="district" nuts="2">District de Haute-Bavière</region>
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<series><title level="j">International Orthopaedics</title>
<idno type="ISSN">0341-2695</idno>
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<imprint><date when="2014">2014</date>
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<front><div type="abstract" xml:lang="en"><sec><title>Purpose</title>
<p>We sought to analyse clinical and oncological outcomes of patients after guided resection of periacetabular tumours and endoprosthetic reconstruction of the remaining defect.</p>
</sec>
<sec><title>Methods</title>
<p>From 1988 to 2008, we treated 56 consecutive patients (mean age 52.5 years, 41.1 % women). Patients were followed up either until death or February 2011 (mean follow up 5.5 years, range 0.1–22.5, standard deviation ± 5.3). Kaplan–Meier analysis was used to estimate survival rates.</p>
</sec>
<sec><title>Results</title>
<p>Disease-specific survival was 59.9 % at five years and 49.7 % at ten and 20 years, respectively. Wide resection margins were achieved in 38 patients, whereas 11 patients underwent marginal and seven intralesional resection. Survival was significantly better in patients with wide or marginal resection than in patients with intralesional resection (<italic>p</italic>
= 0.022). Survival for patients with secondary tumours was significantly worse than for patients with primary tumours (<italic>p</italic>
= 0.003). In 29 patients (51.8 %), at least one reoperation was necessary, resulting in a revision-free survival of 50.5 % at five years, 41.1 % at ten years and 30.6 % at 20 years. Implant survival was 77.0 % at five years, 68.6 % at ten years and 51.8 % at 20 years. A total of 35 patients (62.5 %) experienced one or more complications after surgery. Ten of 56 patients (17.9 %) experienced local recurrence after a mean of 8.9 months. The mean postoperative Musculoskeletal Tumor Society (MSTS) score was 18.1 (60.1 %).</p>
</sec>
<sec><title>Conclusion</title>
<p>The surgical approach assessed in this study simplifies the process of tumour resection and prosthesis implantation and leads to acceptable clinical and oncological outcomes.</p>
</sec>
</div>
</front>
</TEI>
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