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Hemipelvectomy: High-Level Amputation Surgery and Prosthetic Rehabilitation

Houdek, Matthew T. MD; Kralovec, Michael E. MD; Andrews, Karen L. MD

American Journal of Physical Medicine & Rehabilitation: July 2014 - Volume 93 - Issue 7 - p 600–608
doi: 10.1097/PHM.0000000000000068
Invited Review

ABSTRACT: The hemipelvectomy, most commonly performed for pelvic tumor resection, is one of the most technically demanding and invasive surgical procedures performed today. Adequate soft tissue coverage and wound complications after hemipelvectomy are important considerations. Rehabilitation after hemipelvectomy is optimally managed by a multidisciplinary integrated team. Understanding the functional outcomes for this population assists the rehabilitation team to counsel patients, plan goals, and determine discharge needs. The most important rehabilitation goal is the optimal restoration of the patient’s functional independence. Factors such as age, sex, etiology, level of amputation, and general health play important roles in determining prosthetic use. The three main criteria for successful prosthetic rehabilitation of patients with high-level amputation are comfort, function, and cosmesis. Recent advances in hip and knee joints have contributed to increased function. Prosthetic use after hemipelvectomy improves balance and decreases the need for a gait aid. Using a prosthesis helps maintain muscle strength and tone, cardiovascular health, and functional mobility. With new advances in prosthetic components, patients are choosing to use their prostheses for primary mobility.

From the Departments of Orthopedic Surgery (MTH, MEK) and Physical Medicine and Rehabilitation (KLA), Mayo Clinic, Rochester, Minnesota.

All correspondence and requests for reprints should be addressed to Karen L. Andrews, MD, Department of Physical Medicine and Rehabilitation, Mayo Clinic, 200 First St SW, Rochester, MN 55905.

Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article.

© 2014 by Lippincott Williams & Wilkins