Fourteen patients who had a malignant tumor of the pelvic bone, adjacent
to the acetabulum, were managed with a wide en bloc resection that included
most of the hemipelvis as well as the hip. Reconstruction was done with
either a massive allograft or replacement of the resected bone after it had
been autoclaved. The duration of follow-up ranged from four to eleven
years, with a mean of seven years. One osteosarcoma recurred locally, and a
repeat excision was done. Two patients who had had a solitary
supra-acetabular metastasis preoperatively had systemic metastases much
later, but no local recurrence. At the most recent follow-up examination,
twelve patients had no evidence of tumor, and all had a functioning lower
limb. After a minimum of two years, all grafts had healed and were
structurally normal as seen roentgenographically. Later, however, three of
the fourteen grafts had failed by fracture, and numerous other
complications were evident. The described regimens offer superior
functional results compared with other options for management, despite the
complications.