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.
What to Watch For
Pitfalls & Challenges