Reconstruction of Periacetabular Bone Tumor by Vascularized Fibula Graft and Irradiated Autograft

• Published in: Anticancer research Vol. 29; no. 5; pp. 1669 - 1673
• Main Authors: MURAMATSU, Keiichi, IHARA, Koichiro, TANI, Yasuhiro, IWANAGA, Ryuta, TAGUCHI, Toshihiko
• Format: Journal Article
• Language: English
• Published: Attiki International Institute of Anticancer Research 01.05.2009
• Subjects: Adolescent; Biological and medical sciences; Bone Neoplasms - blood supply; Bone Neoplasms - pathology; Bone Neoplasms - therapy; Diseases of the osteoarticular system; Humans; Male; Medical sciences; Neovascularization, Pathologic; Tumors; Tumors of striated muscle and skeleton; Diseases of the osteoarticular system; Irradiated; Osteoarticular system; Autograft; Cancerology; Treatment; Bone tumor; Surgery; Periacetabular bone tumor; irradiated bone graft; Microsurgery; Graft; Bone; vascularized bone graft
• ISSN: 0250-7005; 1791-7530

Background: Periacetabular reconstruction following malignant bone tumor resection for limb saving is extremely challenging. We attempted a new reconstruction method in two patients by combining a free vascularized fibula graft with an extracorporeally irradiated autograft. Patients: A 14-year-old boy with osteosarcoma and a 44-year-old man with chondrosarcoma were treated with wide excision of the tumor, followed by periacetabular reconstruction with an autogenous, extracorporeally irradiated osteoarticular graft combined with a free vascularized fibula graft. Results: Incorporation of the irradiated pelvic bone was achieved without any complications and the resulting limb function was good. Osteoarthritic changes were seen in one patient. Conclusion: This reconstruction method was safe and reliable for primary, limb-sparing surgery. It is best indicated when the femoral head can be preserved and the mechanical strength of the affected acetabulum is maintained.