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

PAR COMPLICATIONS

Menendez et al.⁴, studied 15 patients, none of which had postoperative loosening or migration, but 56% of the patients had a major complication.

ª 5/15 patients had infections that required additional surgery, 3 of which needed revision or removal

ª 2/15 had dislocation, one was associated with infection and both needed revision

ª 1 patient had broken polyethylene liner that required revision

ª 1 patient with extensive heterotopic ossification

INFECTION AND DISLOCATION

CASE 1: Postoperative deep infection. Antibiotic beads placed after prosthetic removal.

     CASE 2: Perioperative dislocation.

CASE 3: Impending dislocation, left. Note angle of polyethylene liner (red arrow). On right, same patient after subsequent dislocation and with deep infection evidenced by antibiotic beads.

CASE 4: Perioperative period, CT scout. Note tiny air bubbles at gray arrowhead.

Same patient as above, deep infection. Prosthesis was removed.

CASE 5: This patient had deep infection. Arthrogram was performed to evaluate for fistula formation. There was no fistula.

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