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Journal of Bone and Joint Surgery - British Volume, Vol 90-B, Issue 9, 1222-1227.
doi: 10.1302/0301-620X.90B9.20758  
Copyright © 2008 by British Editorial Society of Bone and Joint Surgery
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Peri-acetabular resection and endoprosthetic reconstruction for tumours of the acetabulum

P. K. Jaiswal, MRCS, Academic Clinical Fellow1; W. J. S. Aston, FRCS(Trauma & Orth), Specialist Registrar2; R. J. Grimer, FRCS, Consultant Orthopaedic Surgeon3; A. Abudu, FRCS, Consultant Orthopaedic Surgeon3; S. Carter, FRCS, Consultant Orthopaedic Surgeon3; G. Blunn, PhD, Professor of Biomedical Engineering4; T. W. R. Briggs, FRCS, Consultant Orthopaedic Surgeon2; and S. Cannon, FRCS, Consultant Orthopaedic Surgeon2

1 Institute of Orthopaedics
2 Bone Tumour Unit
3 Orthopaedic Hospital Oncology Service, The Royal Orthopaedic Hospital, Bristol Road South, Northfield, Birmingham B31 2AP, UK.
4 Centre of Biomedical Engineering, Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex HA7 4LP, UK

Correspondence should be sent to Dr P. K. Jaiswal; e-mail: pkjresearch{at}googlemail.com

We treated 98 patients with peri-acetabular tumours by resection and reconstruction with a custom-made pelvic endoprosthesis. The overall survival of the patients was 67% at five years, 54% at ten years and 51% at 30 years. One or more complications occurred in 58.1% of patients (54), of which infection was the most common, affecting 30% (28 patients). The rate of local recurrence was 31% (29 patients) after a mean follow-up of 71 months (11 to 147). Dislocation occurred in 20% of patients (19). Before 1996 the rate was 40.5% (17 patients) but this was reduced to 3.9% (two patients) with the introduction of a larger femoral head. There were six cases of palsy of the femoral nerve with recovery in only two. Revision or excision arthroplasty was performed in 23.7% of patients (22), principally for uncontrolled infection or aseptic loosening. Higher rates of death, infection and revision occurred in men.

This method of treatment is still associated with high morbidity. Patients should be carefully selected and informed of this pre-operatively.






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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General