Reconstruction of pelvic defects with polypropylene mesh following resection of primary tumors – A case series

• Published in: Journal of Orthopaedic Reports 2022-12, Vol.1 (4), p.100102, Article 100102
• Main Authors: Regmi, Anil, Niraula, Bishwa Bandhu, Bansal, Shivam, Seenivasagam, Rajkumar Kottayasamy, Pargaie, Ashish, Dhingra, Mohit
• Format: Article
• Language: English
• Subjects: Chondrosarcoma; Ewing's sarcoma; Gait; Hemipelvectomy; Polypropylene mesh; Reconstruction
• ISSN: 2773-157X; 2773-157X
• DOI: 10.1016/j.jorep.2022.100102

Bone and soft-tissue sarcomas arising from the pelvis are difficult to deal with since they present with a large and destructive lesion at the time of presentation, and they often involve neurovascular structures. Internal hemipelvectomy involves the removal of the innominate bone with the adjacent muscles. This study aims to analyze the functional outcome of a patient following internal hemipelvectomy and reconstruct the weight-bearing dome with polypropylene mesh. Between June 2021 and December 2021, 3 patients with large pelvic tumors were operated on by internal hemipelvectomy. Wide resection of the tumor was done, and the periacetabular area was reconstructed with polypropylene mesh. The outcome was analyzed at six months and last follow up at August 2022. In our case series of 3 patients, the average age was 41 years (21–62 years). The male: female ratio is 2:1. The cases were followed up for a mean of 10.33 months(9-12 months). There change in VAS score following surgery up to the 6-month postoperative period (p ​= ​0.0019), and The increase in HHS during the 6-month postoperative period (p ​= ​0.0019) were statistically significant. At final follow up, all patients have acceptable gait, and able to mobilize with walking aids in two patients and without walking aid in one patient. Internal hemipelvectomy, although a moribund surgery for the patient of a primary tumor of the pelvis. Reconstruction with the help of polypropylene mesh promises cost-effective and satisfactory outcomes to patients where floor-level activities play an important role in the activity of daily living.