Background: Periacetabular reconstruction after malignant bone tumor resection to preserve limb function is extremely challenging. The optimal reconstruction method has not yet received consensus and the functional outcomes still remain unsatisfactory.
Case report: A thirteen-year-old girl who was suffering from acetabular osteosarcoma was treated with wide excision of the tumor, followed by periacetabular reconstruction with an autogenous extracorporeal irradiated osteoarticular graft combined with a vascularized fibula graft. Incorporation of the irradiated pelvic bone was achieved despite infection and limb function turned out to be acceptable.
Conclusion: This is the first report on an irradiation-vascularized hybrid autograft to reconstruct massive bone loss in primary limb-sparing surgery.