GIF89aì>³™

INTRODUCTION

PELVIC BONE ANATOMY

CLASSIFICATION OF PELVIC RESECTIONS

SURGICAL OPTIONS FOR THE PERIACETABULAR RESECTION

Hemipelvectomy

Arthrodesis

Megaprosthesis

THE SADDLE PROSTHESIS

Historical Perspectives: The Mark I

Mark II Prosthesis

Periacetabular Reconstruction Prosthesis (PAR)

INDICATIONS

SURGICAL TECHNIQUES AND CONSIDERATIONS

The Notch Osteotomy

Soft Tissue Tension

NORMAL POSTOPERATIVE IMAGING

COMPLICATIONS AND IMAGING

Mark I

Mark II

PAR Page 1

PAR Page 2

RECOVERY AND FUNCTIONALITY

CONCLUSION

REFERENCES

Periacetabular Reconstruction Prosthesis⁴

The latest approach to large acetabular and periacetabular lesions is a modified saddle prosthesis named the 'periacetabular reconstruction' prosthesis (PAR) by Stryker Orthopedics, New Jersey and Menendez et al.

Normal post-operative appearance. Note that 'new' acetabulum is placed proximally compared to contralateral side.

 ª Chrome-Cobalt alloy

 ª Utilizes advances in design of total hip replacement

 ª Allows secure fixation of implant to bone with 3 screws

 ª Provides four times the amount of osseous support compared to Mark II design

ª The ilium is sandwiched between wide plates

ª The wide plates can accommodate great latitude in level of resection

ª Captured polyethylene liner adds stability to loss of soft tissue during surgery

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L- Shaped modular components for customization to maintain length