Background 3D printed prosthetics have become the mainstream method to repair bone defects post pelvic tumor resection. However, the difficulties in soft tissue reconstruction and high rates of prosthetic infection have constrained its clinical applications.

Objective To evaluate the clinical clinical outcomes of combining the modified Ganz and ilioinguinal approach with 3D printed prostheses for the reconstruction of bone and soft tissue defects following pelvic tumor resection.

Methods Retrospective analysis of clinical data of patients undergoing pelvic reconstruction surgery using modified Ganz and ilioinguinal approach combined with 3D printed prostheses in our hospital from February 2019 to January 2022. The MSTS score and Harris score were used to evaluate joint function, and the VAS score was recorded at 3 months, 6 months, and 12 months before and after surgery to evaluate the degree of pain symptom relief. Imaging reexamination was performed to assess tumor recurrence and metastasis. Follow up deadline December 2023.

Results There were 10 male and 9 female patients, with an average age of 46.3 ± 3.6 years (range, 17-74 years). All the patients in this cohort received hemipelvic prosthetic reconstruction as planned. The average surgery time was 486 minutes, and the average blood loss was 2 508.4 ± 1 064.8 mL. There were no perioperative deaths. All patients were followed up for 12 to 27 months, with an average of 21.5 months. Postoperative complications included 2 cases (2/19) of wound complications, 3 cases (3/19) of anterolateral thigh numbness, and 1 case (1/19) of postoperative vascular rupture. Tumor recurrence occurred in 1 case (1/19). At the 12-month follow-up, 4 patients required walking aids, while 15 did not. Preoperative MSTS score was 12.42 ± 3.27 and increased to 23.18 ± 1.34 at 12 months after surgery (t=-9.62, P<0.01). The Harris score improved from 22.06 ± 5.54 preoperatively to 68.56 ± 8.53 at 12 months after surgery (t=-14.42, P<0.01). The preoperative VAS score of 8.3 ± 1.2 decreased to 3.5 ± 1.3 at 12 months after surgery (t=8.57, P<0.01).

Conclusion Using the modified Ganz approach combined with the ilioinguinal route during resection surgery of pelvic zone II tumors provides effective exposure to the ischium and tetrahedron of the pelvis. This method effectively preserves the functionality of soft tissues, such as the gluteal muscles, leading to favorable outcomes.