RECOVERY AND FUNCTIONALITY
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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

 

As previously mentioned, these operations can be quite lengthy. As well, the recovery time is variable and hospitalizations can be quite long. Renard et al.8 had median post-op stays of six weeks.

The patient can be immobilized anywhere from 5-14 days in traction or abduction. Average time to ambulation varied from 8 days up to nine months with extensive physical therapy.1,2,6,8,13,16

In regards to specific studies:

ªCottias et al.16 found that all patients had no pain or mild pain requiring occasional analgesia. Passive motion was limited to mean flexion of 55 degrees. Abduction of 12 degrees and external rotation 16 degrees. Usually ambulatory with crutch or cane.

ª Renard et al.8  found that 7 of 8 patients with primary neoplasia were able to walk with or without aids and without pain.

ª Aboulafia et al.3 claimed 10 of 17 had excellent results being community ambulators without narcotics. 3 were rated as poor and non-ambulatory.

ª Van Der Lei et al.13 had a patient that was walking without pain or support 2.5 years post operatively.

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Benevenia et al.1 found that the saddle prosthesis improves analgesia requirement, independency, and ambulation. And, most should be able to ambulate outside the house with cane and can expect to have a better quality of life despite their metastatic burden.

 


With the PAR prosthesis, Menendez et al.4 found that:

ª Average time to ambulate was 3 weeks with cane or walker and all had trendelenburg gait.

ª Functional evaluations in the remaining live patients 5 good and 9 fair, 1 poor.

ª All of the videos to the above right are of a patient with the PAR prosthesis

 

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The videos below are of a patient with a left-sided PAR prosthesis. Click here for his AP radiograph.

Please wave mouse over black boxes to begin videos.