Modified Harrington reconstruction for advanced periacetabular metastatic disease

Abstract

BACKGROUND/OBJECTIVES: Destructive metastatic lesions about the acetabulum result in pain and functional limitations. We assessed whether periacetabular reconstruction (PAR) improves quality of life by examining outcome measures of pain, function, and mobility. METHODS: Thirty-seven patients with a mean follow-up of 23.6 months (range, 0.5-112 months) were retrospectively reviewed. All patients underwent modified Harrington reconstruction with periacetabular screws, cement, and total hip arthroplasty. RESULTS: The mean preoperative MSTS score of 14 (47%, 14/30) improved to 20 (67%, 20/30) after the procedure. Thirty-five patients who were alive 1 month after the procedure were reviewed for outcome. Postoperatively, patients reported a significant improvement in pain (P < 0.0001), mobility (P < 0.0385), and function (P < 0.0186). Kaplan-Meier survivorship curves showed 59% implant- and 55% patient survival at 2 years; and 49% implant- and 39% patient survival at 5 years. Complications included infection (16%, 6/37) and instability (16%, 6/37). CONCLUSIONS: Our experience with PAR has shown good results with improved postoperative functional scores. Implants will generally exceed life expectancy and are an option to restore quality of life.