Goyal Tarun, Jain Akriti, Ansari Sajid, Paul Souvik, Anthony Michael Leonard
Department of Orthopaedics, All India Institute of Medical Sciences, Bathinda, Punjab, India.
Department of Orthopaedics, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, Indi.
J Orthop Case Rep. 2020 Dec;10(9):33-37. doi: 10.13107/jocr.2020.v10.i09.1894.
The aim of this case report is to present an option of reconstruction in tumors involving the posterior wall and column of the acetabulum with sparing of the anterior column and the weight-bearing dome.
We are reporting a case of a 25-year-old female with histopathologically proven synovial sarcoma involving the left inferior pubic ramus, ischium, and posterior wall of the acetabulum, along with a large soft-tissue extension in the posterior and medial thigh. Wide local excision involving partial acetabular resection and reconstruction using a femoral head allograft was carried out. The patient was allowed full weight-bearing mobilization after 6 weeks. At 3 months' follow-up, the patient was able to walk without support and was able to do active straight leg raising. There were no radiological signs of joint degeneration at the 12-month follow-up.
Reconstruction with non-articular femoral head allograft can be a viable alternative after resection of tumor involving acetabulum. This procedure is expected to support the hip joint and restore function in the short term and recreate bone stock for future arthroplasty if the need arises.
本病例报告的目的是介绍一种针对累及髋臼后壁和柱且保留前柱及负重穹顶的肿瘤的重建方案。
我们报告一例25岁女性,经组织病理学证实为滑膜肉瘤,累及左耻骨下支、坐骨和髋臼后壁,同时在大腿后内侧有较大的软组织延伸。进行了包括部分髋臼切除的广泛局部切除,并使用股骨头同种异体骨进行重建。6周后允许患者完全负重活动。在3个月的随访中,患者能够独立行走,并能够进行主动直腿抬高。在12个月的随访中,没有关节退变的影像学迹象。
使用非关节面股骨头同种异体骨进行重建是髋臼肿瘤切除术后一种可行的选择。该手术有望在短期内支撑髋关节并恢复功能,如有需要还可为未来的关节置换重建骨量。