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

Soft Tissue Tension^3,6

ªSurgeons discovered that the soft tissue ‘tension' (i.e., tendinous attachments of the psoas and the abductors) is critical for post-operative stability.

ªMyodeses are performed and intraoperative testing consisting of range of motion, saddle stability and ease of dislocation is routine.

ªDysfunctional systems must be corrected at the operative time.

ªThe modular intermediate component allows for patient variability to maintain the soft tissue tension.

Intraoperative placement of PAR prosthesis⁴

Specific technique for PAR prosthesis by Menendez et al.:⁴

ª Space posterior to prosthesis packed with gelfoam

ª Spaces between prosthesis and ilium packed with polymethylmethacrylate (see above photo)

ª Femoral component implanted as in total hip replacement

ª Components assembled and trialed, modular components may be needed to maintain optimal length and stability

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