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General Orthopaedics

CHALLENGING THE CONVENTIONAL SURGICAL CORRIDORS: IS THERE A NEED TO REVISIT CONVENTIONAL PELVIC RESECTIONS?

The British Indian Orthopaedic Society (BIOS) Annual Scientific Meeting, Mansfield, England, 7–8 July 2022.



Abstract

Abstract

Background

Conventional periacetabular pelvic resections are associated with poor functional outcomes. Resections through surgical corridors beyond the conventional margins may be helpful in retaining greater function without compromising the oncological margins.

Methods

The study included a retrospective review of 82 cases of pelvic resections for pelvic tumors. Outcomes of acetabulum preservation (Group A) were compared with complete acetabular resection (Group B). Also, we compared outcomes of Type I+half resections (Group 1) with Type I+II resections (Group 2), and Type III+half resections (Group 3) with Type II+III resections (Group 4).

Results

Group A (n=44) had significantly better functional outcome than Group B(n=38) with average MSTS93 score 22.3 vs 20.1 and average HHS 91.3 vs 82.5 (p<0.001). Group 1(n=14) and Group 2(n=12) had similar functional outcomes (mean MSTS93 score 22.07 vs 21.58 (p=0.597) and mean HHS 90.37 vs 86.51 (p=0.205)). Group 3(n=11) had significantly better functional outcome than Group 4(n=17), with mean MSTS93 score 22.8 vs 19.7 (p<0.001) and mean HHS 92.3 vs 80.1 (p<0.001). Oncological outcomes were similar among the groups.

Conclusion

Trans-acetabular pelvic resections provide functional benefit over conventional resections without compromising oncological margins. There is a need to revisit and revise the pelvic resection planes.