Acetabular reconstruction with an ice‐cream cone prosthesis following resection of pelvic tumors: Does computer navigation improve surgical outcome?. Issue 7 (9th March 2020)

• Record Type: Journal Article
• Authors: Fujiwara, Tomohiro; Sree, Deepak V.; Stevenson, Jonathan; Kaneuchi, Yoichi; Parry, Michael; Tsuda, Yusuke; Le Nail, Louis‐Romée; Medellin, Ricardo M.; Grimer, Robert; Jeys, Lee
• Is Part Of: Journal of surgical oncology. Volume 121:Issue 7(2020)
• Page Start: 1104
• Page End: 1114
• Publication Date: 2020-03-09
• Subjects: acetabulum -- bone tumor -- ice‐cream cone prosthesis -- navigation -- reconstruction; Cancer -- Surgery -- Periodicals; Neoplasms -- Periodicals; 616
• DOI: 10.1002/jso.25882
• Languages: English
• ISSNs: 0022-4790

Abstract

Abstract: Background and Objectives: Acetabular reconstruction with a coned‐stem prosthesis has been one of the reliable procedures following pelvic tumor resections but is associated with a risk of complications and postoperative morbidity. We investigated whether navigated reconstruction could decrease the complication rate and optimize outcomes. Methods: A retrospective study was conducted on 33 patients who underwent acetabular resection and reconstruction with ice‐cream cone prostheses; outcomes were compared between the navigated and nonnavigated groups. Results: A clear margin was obtained in 91% and 82% of the navigated and nonnavigated groups, respectively. The local recurrence (LR) rate was 12%, and all LRs occurred in the nonnavigated group. The rate of major complications requiring surgical intervention was significantly lower in the navigated group (9%) than in the nonnavigated group (50%; P = .024). Two implant failures occurred in the nonnavigated group. Functional outcomes were significantly correlated with the occurrence of major complications ( P = .010) and the use of navigation ( P = .043); superior functional scores were observed in the navigated group (Musculoskeletal Tumor Society, 73% vs 55%; Toronto Extremity Salvage Score, 73% vs 56%). Conclusion: Ice‐cream cone prosthesis is an acceptable reconstruction modality following periacetabular tumor resections, and computer navigation are useful to facilitate proper resection margins and implant position.