Background: 

Reconstruction with an endoprosthesis following pelvic tumor resection has increased over the years. However, the long-term results reflect a disappointing frequency of mechanical complications and failures. In an attempt to enhance implant fixation, an electron beam melting (EBM)-based modular hemipelvic endoprosthesis was introduced. Our aim was to explore the preliminary clinical outcomes for patients who have been managed with this prosthesis.

Methods: 

We reviewed the records of 80 consecutive patients who had been managed at a single center between June 2015 and September 2017. Chondrosarcoma was the predominant diagnosis (31.3%). Osseous metastases were diagnosed in 16 patients (20.0%). The position of the reconstructed metallic acetabulum was measured on an anteroposterior pelvic radiograph. Bone ingrowth was evaluated in 2 samples harvested from patients with tumor recurrence.

Results: 

After a median duration of follow-up of 32.5 months (range, 9 to 52 months), no acetabular component instability was detected on radiographs. Histological sectioning of specimens harvested from 2 patients with tumor recurrence showed bone trabeculae extending toward the implant and bone ingrowth within the porous network. At the time of the latest follow-up, 59 patients (73.8%) were alive with no evidence of disease, 5 patients (6.3%) were alive with disease, and 16 patients (20.0%) had died of disease. Local recurrence occurred in 9 patients (11.3%). The mean Musculoskeletal Tumor Society score at the time of the latest follow-up was 83.9% (range, 43% to 100%). Complications occurred in 16 patients (20%), with wound dehiscence being the most common complication (8 patients; 10%). No aseptic loosening was found. Five patients (6.3%) had deep infection, and 2 patients (2.5%) had dislocation.

Conclusions: 

The use of a 3-dimensional (3D)-printed modular hemipelvic endoprosthesis with a highly porous metal interface represents a potential choice as a pelvic endoprosthesis after internal hemipelvectomy for the treatment of a primary or metastatic tumor. These preliminary results demonstrate stable fixation with acceptable early functional and radiographic outcomes.

Level of Evidence: 

Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

中文翻译：

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髋臼周围肿瘤切除术后3D打印的模块化半盆腔内假体重建：80例连续病例的早期结果。

背景： 

这些年来，骨盆肿瘤切除术后使用假体进行重建的情况有所增加。但是，长期结果反映出机械并发症和失败的频率令人失望。为了增强植入物的固定性，引入了基于电子束熔化（EBM）的模块化半盆腔内假体。我们的目的是探讨接受该假体治疗的患者的初步临床结果。

方法： 

我们回顾了2015年6月至2017年9月在同一中心接受治疗的80例连续患者的记录。软骨肉瘤是主要诊断（31.3％）。16例患者被诊断为骨转移（20.0％）。在骨盆前后位片上测量重建的金属髋臼的位置。在从患有肿瘤复发的患者中收集的2个样品中评估了骨的向内生长。

结果： 

在中位随访时间为32.5个月（9到52个月）之后，在X射线照片上未检测到髋臼组件不稳定性。从2例肿瘤复发患者中收集的标本的组织学切片显示，骨小梁向植入物延伸，并且在多孔网络内骨向内生长。在最近一次随访时，有59名患者（73.8％）存活，没有疾病迹象，有5名患者（6.3％）患有疾病，有16名患者（20.0％）死于疾病。9例（11.3％）发生局部复发。最近一次随访时，肌肉骨骼肿瘤学会的平均评分为83.9％（范围为43％至100％）。并发症发生在16例患者中（20％），其中伤口开裂是最常见的并发症（8例； 10％）。没有发现无菌松动。五位患者（6。

结论： 

具有高度多孔的金属界面的3维（3D）打印的模块化半盆腔假体的使用代表了在内部半盆腔切除术后用于治疗原发性或转移性肿瘤的盆腔假体的潜在选择。这些初步结果证明了稳定的固定以及可接受的早期功能和放射学结果。

证据级别： 

治疗级别IV。有关证据水平的完整说明，请参见《作者说明》。