Background: Functional reconstruction following resection of pelvic tumours with the ileum and the acetabulum involvement is challenging and demanding. The aim of this study was to evaluate the results of these patients receiving pelvic reconstruction with a femoral head autograft plus a hemipelvic prosthesis. Methods: Eighteen patients receiving pelvic reconstruction with a femoral head autograft plus a hemipelvic prosthesis following resection of pelvic tumours involving the whole ileum and the acetabulum were included in this study from April 2006 to June 2014. Oncological status, functional results, and complications of these selected patients were analysed. Results: The follow-up was 15–125 months (median 43). The functional MSTS-93 scores of the 18 patients available for the functional analysis were 37–87% (mean 60.7%). Complications occurred in seven patients (31.8%); dislocation in two (9%); and deep infection in three patients (13.6%) and two patients healed well following thorough debridement and antibiotic treatment. Five patients had local recurrence (22.7%). Lung metastases occurred in eight patients; seven died of disease and one lived after the metastasectomy. The 5-year overall Kaplan–Meier survival and disease-free survival rates were 61.7% and 50%, respectively. Conclusions: The procedure of femoral head autograft plus hemipelvic prosthesis was an effective method to reconstruct the defect following the whole ileum and the acetabulum resection; the functional outcomes were satisfactory, and it had an acceptable complication rate. Keywords: Pelvic tumour, Limb salvage surgery, Orthopaedic oncology, Prosthesis, Autograft
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