The Harrington plus reconstruction for pelvic and acetabular metastases

Background: Surgical management of periacetabular bone metastases is challenging. The Harrington Plus reconstruction is a modification of the original Harrington rod technique. An intrapelvic suprapectineal plate is used, with the aim of reconstructing a disrupted anterior column and reducing the ri...

Full description

Bibliographic Details
Main Authors: Mukai Chimutengwende-Gordon, Ross Coomber, Fidel Peat, Nadim Tarazi, Daud Chou, Andrew Carrothers
Format: Article
Language:English
Published: Elsevier 2022-04-01
Series:Journal of Bone Oncology
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2212137422000045
Description
Summary:Background: Surgical management of periacetabular bone metastases is challenging. The Harrington Plus reconstruction is a modification of the original Harrington rod technique. An intrapelvic suprapectineal plate is used, with the aim of reconstructing a disrupted anterior column and reducing the risk of failure in cases where there is extensive medial bone loss. Methods: A retrospective review of the 13 patients who have undergone the Harrington Plus procedure to date was performed. Mobility status, EQ5D and Oxford Hip scores were assessed. Results: There was a significant improvement in mobility status, EQ5D and Oxford Hip Scores at 6 months postoperatively (p < 0.05). Two patients returned to theatre for debridement of infection. There were no postoperative dislocations, cup medialisation or cases of loosening of the prosthesis. No patient required revision arthroplasty surgery. Conclusion: The Harrington Plus procedure produces a reliable construct that allows patients with extensive periacetabular metastatic defects to fully weight-bear. Careful patient selection and multidisciplinary management is essential.
ISSN:2212-1374