Precision acetabular tumor resection and reconstruction using custom prosthesis with the help of Computer Assisted Navigation System

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Objective To investigate an effective method to reconstruct acetabular defect using custom prosthesis after tumor En-bloc resection with the help of Computer Assisted Navigation System(CANS).Methods 3D model of image fusion was reconstructed using the preoperative CT and MRI data.The tumor invasion range,the safe resection boundaries and osteotomy planes were marked on the 3D model.A custom acetabular prosthesis was designed and manufactured using CAD/CAM techniques according to pelvic defects.With the help of CANS,the tumor was accurately resected and the custom prosthesis was fixed precisely according to the preoperative planning.We formulated the innovative treatment process.Between December 2010 and May 2012,3 patients with primary malignant acetabular tumor underwent the treatment process.They were males,aged from 30 to 55 years.There were 2 cases of chondrosarcoma and 1 case of primitive neuroectodermal tumor (PNET).The tumors involved zone Ⅱ +Ⅲ in all of cases.All 3 patients were followed up,and complications,MSTS score and prognosis were recorded.Results The tumors in all 3 cases were resected successfully,and the acetabular defects were reconstructed precisely with custom prosthesis.All the 3 patients were followed up for 12 to 21 months.At the final follow-up,3 patients survived without recurrence.No such complications as deep infection,dislocation,prosthesis loosening and screw broken occurred during the follow-up period.The MSTS score was 18-26.Conclusion The process is effective for the treatment of acetabular tumors.Acetabular tumor can be En-bloc resected safely and custom prosthesis can be fixed precisely with the help of CANS.According to the process,accurate tumor resection and precise reconstruction can be achieved.The rate of complications is low.The short-term result is fine,while the long-term result needs further observation. Key words: Acetabulum; Neoplasms; Surgery, computer-assisted; Prostheses and implants