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FUNCTIONAL AND ONCOLOGIC OUTCOME FOLLOWING TYPE I PELVIC RESECTION FOR BONE TUMORS WITH AND WITHOUT RECONSTRUCTION.



Abstract

Introduction and Aims: The management of bone defects created by Type 1 pelvic resections of large iliac bone tumors remains controversial. We reviewed the functional and oncologic outcome following Type I resection with and without bone reconstruction.

Method: A retrospective review of our prospectively collected database was undertaken analysing functional and oncological outcome of 16 patients with Type I pelvic resections. Minimum follow-up was 12 months (range 12–96 months). Outcome data was available on eight of 10 patients managed without reconstruction (WOR), with the residual ilium allowed to collapse back onto the sacrum, and on five of six patients with bone graft reconstruction (WR). Functional outcome was assessed by the Toronto Extremity Salvage score (TESS) and the Musculoskeletal Tumor Society scores (MSTS87 and MSTS93).

Results: Average age at surgery was 33 years (WOR) and 48 years (WR), (p=0.04), with average maximal tumor dimensions of 12cm and 9cm respectively (p=0.1). The most frequent diagnosis was chondrosarcoma. The WOR group average TESS, MSTS 87 and MSTS 93 scores were respectively 73%, 18/35 and 58% at an average of 50 months (range 24–96 months) compared to 69%, 21/35 and 51% at an average of 37 months (range 12–60 months) for the WR group. Thirty-three percent of WOR and 20% of WR patients did not require walking aids. Infection or wound necrosis occurred in 40% of WOR patients and 50% of WR patients. No local recurrences were identified.

Conclusion: Similar functional and oncologic outcome was achieved in both groups suggesting that bone reconstruction is not justified following Type I pelvic resection.

These abstracts were prepared by Editorial Secretary, George Sikorski. Correspondence should be addressed to Australian Orthopaedic Association, Ground Floor, The William Bland Centre, 229 Macquarie Street, Sydney, NSW 2000, Australia.

At least one of the authors is receiving or has received material benefits or support from a commercial source.