Systematic review on Options of pelvic reconstruction in musculoskeletal sarcomas

ABSTRACT: Given the large bony defects, complex anatomy and challenging complication rates, pelvic reconstruction after musculoskeletal sarcomas remains a difficult problem in orthopaedic oncology. This systematic review analyzes the current reconstructive options: biological reconstruction, endoprosthetic reconstruction, hip transposition and patient-specific three-dimensional (3D)-printed implants. A systematic literature search was conducted in line with the guideline of PRISMA in order to evaluate functional outcomes, complications, implant survival, and further research. There is indications that no single reconstruction system is better than the others. Prosthetic reconstruction will provide immediate stability and an earlier opportunity for mobilization, but come at a cost of infection, dislocation and mechanical failure. The long-term durability is possible using biological reconstruction; however, there are limitations that are related to graft healing. Early functional and anatomical results of emerging 3D-printed custom implants are promising. Optimizing outcomes after resection of a pelvic sarcoma is still very much dependent on individualized reconstruction based on the characteristics of the tumor, patient factors and functional requirements. Keywords: Pelvic sarcoma; Internal hemipelvectomy; Pelvic reconstruction; Hemipelvic prosthesis; 3D-printed implant; Limb salvage surgery; Orthopaedic oncology.