Metastatic disease to the hip and pelvis: Surgical management

Metastatic disease to the pelvis and lower extremity is a significant contributor to morbidity in patients with metastatic cancer. When indicated, surgical prevention of pathologic fractures and treatment of established fractures can preserve patient mobility, dramatically increase pain control, and prevent associated co-morbidities. Forty percent of bony metastases occur in the pelvis and 25% in the femur. Because of the limited life expectancy and debilitated nature of patients undergoing palliative surgery for metastatic disease, the surgical construct should allow immediate unrestricted weight bearing. All areas of the bone should be imaged and all significantly involved portions of the bone should be addressed with the reconstruction. Postoperative radiation therapy should be considered. With appropriate technique and implant selection, outcomes of surgical management are generally very good.