Ice-Cream Cone Prothesis Reconstruction in the Treatment of Metastatic Diseases in The Acetabulum

Öz

Skeletal metastasis is a common cause of severe morbidity, reduction in quality of life and often early mortality. A 73-year-old man was referred to our department complaining of pain in her hip. Plain radiographs showed lesions at the acetabulum. In this study, we describe the case of patient who modified surgical technique for the reconstruction of severe pelvic bone loss treated using a coned acetabular prosthesis with a stem extension inside the ilium (the stanmore ‘icecream’ cone prosthesis). This case report provides guidelines for systematic assessment of patients with periacetabular lesions, including risk management, surgical and non-operative treatment options.

Anahtar Kelimeler

• Acetabular lesion,metastasis,treatment,Ice-Cream Cone,Prothesis

Asetabüler Metastatik Karsinomda Dondurma Konisi Protez Rekonstrüksiyonu: Olgu Sunumu Eşliğinde Literatürün Gözden Geçirilmesi

Öz

İskelet metastazı ciddi morbidite, yaşam kalitesinde azalma ve sıklıkla erken mortalitenin nedenidir. Yetmişüç yaşında erkek hasta kliniğimize kalça ağrısı şikayeti ile başvurdu. Düz grafide asatabulumda lezyonlar saptandı. Bu çalışmada, dondurma konisi protez kullanarak rekonstrüksiyonu gerçekleştirdiğimiz hastamızı ve eşliğinde periasetabular bölge metastazlarına yaklaşımı sunmaktayız. Bu olgu sunumu risk yönetimi, cerrahi ve cerrahi olmayan tedavi seçenkleri dahil olmak üzere periasetabuler lezyonlu hastaların sistemik değerlendirmesinde kılavuzlar sağlamaktadır.

Anahtar Kelimeler

• Periasetabuler lezyon,metastaz,tedavi,dondurma konisi,protez

Kaynakça

1. 1. Campanacci M. Bone and soft tissue tumors: clinical features, imaging, pathology and treatment. 2013: springer science & business media.
2. 2. Issack PS,Kotwal SY, Lane JM. Management of metastatic bone disease of the acetabulum. The Journal of the american academy of orthopaedic surgeons. 2013;21(11):685-95.
3. 3. Santini Det al. Natural history of malignant bone disease in renal cancer: final results of an ıtalian bone metastasis survey. Plos one, 2013. 8(12): p. E83026.
4. 4. Rossi G, et al. Embolisation of bone metastases from renal cancer. La radiologia medica. 2013;118(2):291-302.
5. 5. Muller DA, Capanna R. The surgical treatment of pelvic bone metastases. Advances in Orthopedics. 2015;2015:525363.
6. 6. Angelini A, Calabro T, Pala E, Trovarelli G, Maraldi M, Ruggieri P. Resection and reconstruction of pelvic bone tumors. Orthopedics. 2015;38(2):87-93.
7. 7. Enneking Wd, Gebhardt M, Malawar M, and Pritchard D. A systemfortheclassificationofskeletal resections. Chir Organi Mov. 1990;75(1 Suppl):217-40.
8. 8. Harrington KD.The management of acetabular insufficiency secondary to metastatic malignant disease. 1981;63:653-64.

9. 9. Quinn RH. Metastatic disease to the hip and pelvis: surgical management." Techniques in Orthopaedics.2007;22.2:78-87.
10. 10. Marco RA, Sheth DS, Boland PJ, Wunder JS, SiegelJA, &Healey JH. Functional and oncological outcome of acetabular reconstruction for the treatment of metastatic disease. The Journal of Bone & Joint Surgery,2000;82(5):642.
11. 11. Shahid M, Saunders T, Jeys L, Grimer R. The outcome of surgical treatment for periacetabular metastases. Bone & joint journal. 2014;96b(1):132-6.
12. 12. Colman MW, karim SM, hirsch JA, Yoo AJ, Schwab JH, hornicek FJ, et al. Percutaneous acetabuloplasty compared with open reconstruction for extensive periacetabular carcinoma metastases. The journal of arthroplasty. 2015;30(9):1586-91.
13. 13. Bernthal NM, Price SL, Monument MJ,Wilkinson B, Jones KB,Randall RL. Outcomes of modified harrington reconstructions for nonprimary periacetabular tumors: an effective and ınexpensive technique. Annals of surgical oncology. 2015;22(12):3921-8.
14. 14. Clayer M. The survivorship of protrusio cages for metastatic disease involving the acetabulum. Clinical orthopaedics and related research. 2010;468(11):2980-4.
15. 15. Tillman RM, Myers GJC, Abudu AT, Carter SR, Grimer RJ. The three-pin modified 'harrington' procedure for advanced metastatic destruction of the acetabulum. Journal of Bone and Joint Surgery-British. 2008;90b(1):84-7.
16. 16. Ho L, Ahlmann ER, Menendez LR. Modified harrington reconstruction for advanced periacetabular metastatic disease. J Surg Oncol. 2010;101(2):170-4.
17. 17. Hoell S, Dedy N, Gosheger G, Dieckmann R, Daniilidis K, Hardes J. The burch-schneider cage for reconstruction after metastatic destruction of the acetabulum: outcome and complications. Archives of Orthopaedic and Trauma Surgery. 2012;132(3):405-10.
18. 18. Fisher NE, Patton JT, Grimer RJ, Porter D, Jeys L, Tillman RM, et al. Ice-cream cone reconstruction of the pelvis: a new type of pelvic replacement early results. Journal of Bone and Joint Surgery-British. 2011;93b(5):684-8.
19. 19. Lozano-calderon SA,Kaiser CL,Osler PM, Raskin KA. Cemented total hip arthroplasty with retrograde ıschioacetabular steinmann pin reconstruction for periacetabular metastatic carcinoma. Journal of Arthroplasty. 2016;31(7):1555-60.
20. 20. Khan FA, Rose PS, Yanagisawa M, Lewallen DG, Sim FH. Surgical technique: porous tantalum reconstruction for destructive nonprimary periacetabular tumors. Clinical Orthopaedics and Related Research. 2012;470(2):594-601.
21. 21. Benevenia J, et al. "Treatment of advanced metastatic lesions of the acetabulum using the saddle prosthesis." Clinical Orthopaedics and Related Research. 426 (2004): 23-31.