The Use of LUMIC Prosthesis for the Treatment of Periacetabular Metastases.

Abstract

Metastases from malignant tumors most commonly occur in the axial skeleton (spine, ribs and pelvis). Bony metastases most often arise from breast, prostate and kidney cancer as well as myeloma, in which patient survival is relatively long. Large lytic defects within the pelvis, and especially the acetabular area, necessitate surgical treatment with specially designed prostheses, which significantly improves the patients' quality of life. The aim of the study was to determine the indications and early outcomes and describe the surgical technique of implantation of the Lumic prosthesis. Over the period 2011-2015, six patients underwent resection of periacetabular area metastases followed by implantation of a Lumic prosthesis in the Orthopedic Department in Brzozów. The surgical procedures and their outcomes were assessed with special regard to pain intensity, physical functioning and mobility of patients. The surgeries were performed from an inverted 'S'-shaped approach with a margin of healthy tissue and acetabula were implanted without cement (in 2 patients) and using bone cement (in 4 patients). Post-operative pain intensity was significantly lower (3.4 in a VAS scale) and the patients' physical function improved (65 in Karnofsky scale). There were no intra- or post-operative complications. Deterioration in muscular function associated with the surgical technique was acceptable as the surgery enabled the patients to walk. 1. Surgical intervention in patients with periacetabular metastases often requires the use of modular or custom-made implants. 2. Radiotherapy is a complementary treatment or is reserved for use in patients in poor general health. 3. An alternative to the Lumic prosthesis is a custom-made prosthesis produced with 3D printing technology.