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Periacetabular Reconstruction with a New Endoprosthesis
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Symposium: Selected Papers Presented at the 2008 Meeting of the Musculoskeletal Tumor Society
Periacetabular Reconstruction with a New Endoprosthesis
Lawrence R. Menendez1, Elke R. Ahlmann2, Yuri Falkinstein3 and Daniel C. Allison2, 4 
| (1) |
Department of Orthopedics, Keck School of Medicine, University of Southern California + Los Angeles County Medical Center, USC University Hospital, 1510 San Pablo Street, Suite 634, Los Angeles, CA 90033, USA |
| (2) |
Department of Orthopedics, University of Southern California + Los Angeles County Medical Center, 1200 N. State Street, GNH 3900, Los Angeles, CA, 90033,
USA |
| (3) |
Department of Orthopedics, Division of Spine Surgery, Providence Saint Joseph Medical Center, 501 S. Buena Vista St, Burbank, CA, 91505,
USA |
| (4) |
Department of Orthopedics, Division of Musculoskeletal Oncology, Southern California Permanente Medical Group, 1011 Baldwin Park Blvd, Baldwin Park, CA, 91706, USA
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Received: 16 December 2008 Accepted: 31 July 2009 Published online: 20 August 2009
Abstract Reconstruction of the Type II pelvic resection is challenging. Currently available reconstructive options have inherent problems
including graft and implant failure, pain, poor function, and high major complication rates. The periacetabular reconstruction
(PAR) endoprosthesis was designed to be secured with internal fixation and bone cement to the remaining ilium and support
a reconstructed acetabulum. This construct potentially avoids the complications of graft or hardware failure, while maintaining
early mobilization, comfort, limb lengths, and function. We retrospectively reviewed 25 patients who underwent Type II pelvic
resection and reconstruction with the PAR endoprosthesis, analyzing function, complications, and survivorship. The minimum
followup was 13 months (mean, 29.4 months; range, 13 to 108 months). We compared the PAR data with the literature for the
Mark II saddle endoprosthesis. The PAR’s average MSTS score was 20.8 (67%), major complications occurred in 14 (56%), and
implant survivorship was 84% at 2 years and 60% at 5 years. The rate of failure at the ilium-saddle interface was lower and
implant survivorship higher than those in the published literature for the Mark II saddle. We recommend use of the PAR endoprosthesis
for reconstruction of large defects following Type II pelvic resection. The modified saddle design provides greater inherent
stability, allowing for faster rehabilitation and improved longevity without increased complications and is an improvement
over the currently available saddle prostheses.
Level of Evidence: Level III, retrospective case series. See Guidelines for Authors for a complete description of levels of evidence.
The lead author (LRM) is a consultant for Stryker, has patents on the device reported, and certifies that he has or may receive
payments or benefits from a commercial entity related to this work.
Each author certifies that his or her institution has approved the human protocol for this investigation and that all investigations
were conducted in conformity with ethical principles of research, and that informed consent for participation in the study
was obtained.
The study was performed at University of Southern California + Los Angeles County Medical Center, Los Angeles, CA.
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