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Computer-Navigated Bone Cutting in the Resection of a Pelvic Bone Tumor and Reconstruction with a Massive Bone Allograft
Pierre-Louis Docquier, MD, PhD1; Olivier Cartiaux, PhD2; Laurent Paul, PhD1; Christian Delloye, MD, PhD3; Xavier Banse, MD, PhD1
1 Université Catholique de Louvain, Center for Research in Computer Assisted and Robotic Surgery, Institute of Experimental and Clinical Research, 53 Avenue Mounier (Tour Pasteur +4), B-1200 Brussels, Belgium
2 Department of Mechanical Engineering, Ecole Polytechnique de Montréal, P.O. Box 6079, Station Centre-ville, Montreal, QC H3C3A7, Canada. E-mail address: olivier.cartiaux@polymtl.ca
3 Department of Orthopaedic Surgery, Saint-Luc University Hospital, 10 Avenue Hippocrate, B-1200 Brussels, Belgium
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Based on an original article: J Bone Joint Surg Am. 2010;92:2076-82.

Disclosure: None of the authors received payments or services, either directly or indirectly (i.e., via his or her institution), from a third party in support of any aspect of this work. None of the authors, or their institution(s), have had any financial relationship, in the thirty-six months prior to submission of this work, with any entity in the biomedical arena that could be perceived to influence or have the potential to influence what is written in this work. Also, no author has had any other relationships, or has engaged in any other activities, that could be perceived to influence or have the potential to influence what is written in this work. The complete Disclosures of Potential Conflicts of Interest submitted by authors are always provided with the online version of the article.

Copyright © 2011 by The Journal of Bone and Joint Surgery, Inc.
JBJS Essential Surgical Techniques, 2011 Aug 24;01(02):e10 1-8. doi: 10.2106/JBJS.ST.K.00013
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We present here a surgical technique using a navigation system and an oscillating saw for the resection of a pelvic bone tumor combined with an allograft reconstruction.

Step 1: Preoperative Planning

The surgeon and radiologist together delineate the tumor on each magnetic resonance imaging (MRI) slice; then the surgeon defines target planes for tumor resection and transfers them to the allograft.

Step 2: Patient Positioning and Surgical Exposure

With the patient in the lateral decubitus position, combine ilioinguinal with iliocrural and obturator surgical approaches to expose the ilium.

Step 3: Navigated Tumor Resection

Perform the osteotomies using the navigation system to guide the saw blade, following predefined target planes; perform a biopsy.

Step 4: Navigated Allograft Cutting

Perform the osteotomies using the navigating saw, following the same target planes as used for the tumor resection.

Step 5: Pelvic Reconstruction

Fix the graft and cement a femoral stem in place; then reinsert all detached tendons and elevated muscles.

Results & Preop./Postop. Images

Editor's note: This technique is based on preliminary work that has not been presented in a peer-reviewed case series publication.

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    Accreditation Statement
    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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