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 resection with saddle prostheses indicated in cases which:^6,8

1- Surgical margin obtained similar to those with hemipelvectomy can be accomplished.

2- Resection for preservation of reasonably functional limb.

3- Life expectancy and physical status can justify procedure.

Contraindications:^6,8

1- recurrence following previous limb sparing procedure UNLESS can resect the tumor completely (see example).

2- extension through SI joint, with involvement of sacral nerves and root foramen

3- extensive soft tissue infiltration

4- poor physical status

5- osteoporosis (relative contraindication)

Hypervascular renal cell carcinoma that needed embolization prior to placement of saddle prosthesis

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AP Pelvis with left acetabular lytic metastasis

Frog leg lateral, same patient as above

Axial CT. Same patient as above.