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Functional Results and Quality of Life After Treatment of Pelvic Sarcomas Involving the Acetabulum
C. Hoffmann, MD1; G. Gosheger, MD1; C. Gebert, MD1; H. Jürgens, MD1; W. Winkelmann, MD1
1 Departments of Orthopedics (C.H., G.G., C.G., and W.W.) and Pediatric Hematology and Oncology (H.J.), University of Münster, Albert Schweitzer Strasse 33, 48129 Münster, Germany. E-mail address for C. Hoffmann: christiane-hoffmann@arcor.de. E-mail address for G. Gosheger: goshegg@uni-muenster.de. E-mail address for C. Gebert: cgebert@uni-muenster.de. E-mail address for H. Jürgens: jurgh@uni-muenster.de. E-mail address for W. Winkelmann: fiegehi@mednet.uni-muenster.de
View Disclosures and Other Information
In support of their research for or preparation of this manuscript, one or more of the authors received grants or outside funding from Deutsche Krebshilfe German Cancer Aid. None of the authors received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.
Investigation performed at the Departments of Orthopedics and Pediatric Hematology and Oncology, University of Münster, Münster, Germany

The Journal of Bone and Joint Surgery, Incorporated
J Bone Joint Surg Am, 2006 Mar 01;88(3):575-582. doi: 10.2106/JBJS.D.02488
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Background: Limb salvage after resection of a pelvic sarcoma that involves the acetabulum represents a surgical challenge. The ideal method of reconstruction after acetabular resection remains a subject of controversy, and the outcome in terms of the impact of therapy is still unknown. The purpose of this study was to determine the impact of surgery on health-related quality of life and function after acetabular resection.

Methods: Eighty-one patients with a pelvic sarcoma underwent acetabular resection at a single institution. Functional evaluation and quality-of-life examination were performed in forty-five patients, and these patients comprised the study group. Quality of life was assessed with use of the European Organization for Research and Treatment of Cancer core quality-of-life questionnaire. Function was assessed with use of the Musculoskeletal Tumor Society system.

Results: The median age of the patients was 30.4 years at the time of the acetabular resection and 35.7 years at the time of follow-up. The median time interval from the index operation to the latest follow-up was sixty-nine months. At the latest follow-up evaluation, the mean functional status score was 14.5 points of a maximum of 30 points. In a comparison of endoprosthetic replacement and hip transposition following resection, significantly better functional results (p = 0.017) and a lower number of complications were found in patients who had a hip transposition. Quality-of-life assessment results were also better in patients with a hip transposition, especially in role functioning (p = 0.043).

Conclusions: On the basis of the low complication rate and the good functional and quality-of-life results, hip transposition after acetabular resection seems to be the optimal technique for treating patients with a pelvic sarcoma involving the acetabulum.

Level of Evidence: Therapeutic Level III. See Instructions to Authors for a complete description of levels of evidence.

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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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