Limb salvage surgery for pelvic osteosarcoma

Patients with pelvic osteosarcoma have a poor outcome; treatment is one of the most challenging problems for the orthopedic oncologist. The reconstructive approach varies according to anatomic location, extent of resection, the patient’s functional demands, and individual surgeon preference. The choice of optimal technique for reconstruction after acetabular tumor resection depends on numerous parameters and includes iliofemoral arthrodesis or pseudoarthrodesis, combined use of hip arthroplasty with massive allograft or recycled autograft, and pelvic and saddle prosthesis. The type of reconstruction modality can influence the rate of infection. Hip transposition resulted in the least incidence of complications after resection of the acetabulum, compared to the use of prosthesis or prosthesis and allograft. The absence of large implants and allografts helps reduce surgical time, facilitates closure, and may decrease the incidence of infection and late revision due to implant failure. These can lead to early postoperative systemic treatment and functional recovery and are critical for patients with a high incidence of local recurrence and distant metastases. We believe that resection arthroplasty should be indicated for the patient with acetabular osteosarcoma.