Pelvic Tumour Reconstruction Using Patient-Specific FTL Cup for Acetabular and Ischial Involvement

Patient overview

A 31-year-old male was diagnosed with a tumour in the left pelvis affecting both the ischium and acetabulum. The tumour was malignant and showed rapid progression, making timely and precise intervention critical.

Given the anatomical location and extent of involvement, no off-the-shelf implant was suitable — the case required a patient-specific FTL Cup.

Preoperative consideration

The tumour sat in a structurally critical region of the pelvis, so resection would directly affect both bone integrity and joint reconstruction. Planning had to ensure complete tumour removal, preservation of viable bone, and feasibility of implant fixation after resection.

Defining the resection strategy

The engineering team, working closely with the surgeon, planned the resection cuts required to remove the tumour along with the affected bone. This planning phase formed the foundation for both tumour clearance and the subsequent reconstruction.

Resection execution using patient-specific jigs

Patient-specific resection jigs were designed and manufactured to execute the planned cuts intraoperatively, guiding precise bone resection and ensuring alignment with the preplanned surgical approach.

Custom implant placement

Following tumour resection, a custom FTL Cup was placed to cover the resulting defect and support hip joint reconstruction. It was fixed with locking and compression screws at the ilium and pubis, with suture holes at the ischial region for soft-tissue reattachment.

Drilling jigs were used intraoperatively to create pilot holes aligned with the preplanned screw trajectories, giving controlled and reliable fixation.

Hip joint reconstruction

After secure fixation of the FTL Cup, the hip joint was reconstructed with a standard cemented hip implant and a femoral stem, restoring joint articulation following tumour resection.

Clinical significance

This case demonstrates the use of a patient-specific FTL Cup to manage a complex pelvic tumour involving the acetabulum and ischium. The combination of planned resection, surgical jigs and custom implant design enabled a structured approach to both tumour removal and reconstruction, in a case where standard solutions were not feasible.