Type lll internal hemipelvectomy for primary bone tumours with and without allograft reconstruction

Aim There is insufficient evidence to support bony reconstruction of the pubis after a type III internal hemipelvectomy (resection of all or part of the pubis). In this study, we compared surgical complications, postoperative pain, and functional outcome in a series of patients who had undergone a type III internal hemipelvectomy with or without bony reconstruction. Methods In a retrospective cohort study, 32 patients who had undergone a type III hemipelvectomy with or without allograft reconstruction (n = 15 and n = 17, respectively) were reviewed. The mean follow-up was 6.7 years (SD 3.8) for patients in the reconstruction group and 6.1 years (SD 4.0) for patients in the non-reconstruction group. Functional outcome was evaluated using the Musculoskeletal Tumor Society (MSTS) scoring system and the level of postoperative pain with a visual analogue scale (VAS). Results The mean MSTS score of the patients was significantly better in patients after reconstruction (26 (SD 1.7) vs 22.7 (SD 2.0); p < 0.001). The mean visual analogue scale score for pain was significantly less in the reconstruction group (2.1 (SD 2) vs 4.2 (SD 2.2); p = 0.016). One infection occurred in each group. Bladder herniation occurred in three patients (17.6%) in the non-reconstruction group but none in the reconstruction group. Five patients (29.4%) in the non-reconstruction group and one (7%) in the reconstruction group had a limp. Graft displacement occurred in two patients in the reconstruction group. Conclusion We recommend reconstruction of the bony defect after a type III hemipelvectomy: it gives a better functional result, less postoperative pain, and fewer late surgical complications. Cite this article: Bone Joint J 2021;103-B(6):1155–1159.

Cranial internal hemipelvectomy (iliectomy) with limb sparing for a dog with ilial chondrosarcoma: a case report

Objective: To describe the outcome following limb-sparing subtotal hemipelvectomy (iliectomy) in a dog with ilial chondrosarcoma. Animal: A 9.5-year-old female spayed Boxer with grade 2 chondrosarcoma of the ilium Study Design: Case report.

Chondrosarcoma pelvis, beyond the boundaries.

Objectives: The objective of our study to find the outcome of extensive chondrosarcoma pelvis after surgery. Study Design: Case Series study. Setting: Department of Orthopaedic Surgery Dow University of Health Sciences / Civil Hospital Karachi. Period: From April 2014 to December 2018. Material & Methods: Seven patients with Chondrosarcoma pelvis included in this study. Results: All Seven patients were male. 2 patient age was in 20’s, three in 40’s and two in 60’s with median age of 44. Clinically presentation of patients was variable. One patient present with groin lump, one with pain and swelling lower abdomen, three with hip pain, one patient with severe gluteal pain and lump, one with massive lump extending from the mid abdomen to groin and urine retention and constipation. Five patients have left pelvis involved and two have right side. Two patients have pubic bone and ischium (Level III) involved, two have ilium (Level I) and three have ilium, acetabulum and pubis (Level I, II, III). Two patients with have preoperatively sciatic nerve palsy. Two patients have medical comorbid. One was asthmatic and one had psychiatric illness. No patient had metastasis at presentation. Pubis and ischium with tumor resected in two cases, partial ilium resection in one case, one complete P1 resection with sciatic nerve, one patient have internal hemipelvectomy and one patient had internal hemipelvectomy that bone recycled in liquid nitrogen and pelvis re-implanted and fixed with recon plates and hip joint reconstructed with total hip replacement. One patient had external hemipelvectomy due to pus at tumor site. Total duration of surgery in patient having thirteen hours, and remaining have 3 to 5 hours. Blood loss during these surgeries was in between 1000 to 1200 ml. Three patients have wound infection, one patient had L5 nerve root injury. Patient with external hemipelvectomy develop wound dehiscence and uro-cutaneous fistula. Two patients died, one with recycled bone after 15 months due cardiac problem and 2nd due to disease related complications within 3 months of surgery. Conclusion: Pelvic chondrosarcoma must be operated by the team of surgeons including orthopaedic surgeon, urologist and general surgeon because of the tumor presents with massive lumps due to unrestricted compartment and can involve the important pelvic organ. With team any complication can be prevented and treated immediately.