Hip transposition as a limb salvage procedure following the resection of periacetabular tumors

Background and objectives: One of the most difficult problems in tumor surgery is the treatment of pelvic tumors, particularly those in the periacetabular region. This retrospective study serves to analyze clinical and functional outcome of the new surgical technique of hip transposition.

Patients and methods: Sixty-two patients were analyzed (chondrosarcoma 15, Ewing's sarcoma or PNET 26, osteosarcoma 14, synovial cell sarcoma 2, others 5) and clinical, oncological, and functional outcome were evaluated.

Results: The surgical procedure focused on hip transpositions Type I (n = 9), Type IIa using the MUTARS attachment tube (n = 36), and Type IIb using the MUTARS attachment tube with a proximal femur endoprosthesis and bipolar cup (n = 17). In 53 patients (85.5%), wide margins were achieved. The 1- and 5-year overall survival rates were 96.4% and 80.5%, respectively. The 5-year (10 years) overall survival was 82.1% (82.1%) for Ewing's sarcoma, 60.1% (40.6%) for osteosarcoma, and 92.3% (46.2%) for chondrosarcoma. Wound healing problems were observed in 14 cases, deep infection in 20 cases. The mean Musculoskeletal Tumor Society (MSTS) score was 62% (18.6 Pts ± 3.73).

Conclusion: Hip transposition can be considered as an easy and safe surgical procedure to employ in order to achieve good functional outcome in periacetabular tumors.