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Fourteen patients who had a malignant tumor of the pelvic bone, adjacent to the acetabulum, were managed with a wide en bloc resection that included most of the hemipelvis as well as the hip. Reconstruction was done with either a massive allograft or replacement of the resected bone after it had been autoclaved. The duration of follow-up ranged from four to eleven years, with a mean of seven years. One osteosarcoma recurred locally, and a repeat excision was done. Two patients who had had a solitary supra-acetabular metastasis preoperatively had systemic metastases much later, but no local recurrence. At the most recent follow-up examination, twelve patients had no evidence of tumor, and all had a functioning lower limb. After a minimum of two years, all grafts had healed and were structurally normal as seen roentgenographically. Later, however, three of the fourteen grafts had failed by fracture, and numerous other complications were evident. The described regimens offer superior functional results compared with other options for management, despite the complications.
K D Harrington (Sun,) studied this question.