Surgical treatment for metastatic disease of the pelvis and the proximal end of the femur.

Advances in the treatment of invasive cancers continue to improve the longevity of patients who have these diseases; thus, the care of patients who have bone metastases is an issue of the utmost importance to the orthopaedic surgeon. In terms of maintaining the ability to walk, no site of potential metastatic involvement is more crucial than the proximal end of the femur and the acetabulum. Advances in femoral and acetabular implants, imaging modalities, and operative techniques now allow reconstruction of even the most complex acetabular and proximal femoral defects. However, the orthopaedic surgeon must recognize the need to approach management of these patients from a multidisciplinary perspective. The oncologist, radiotherapist, rehabilitation medicine specialist, radiologist, and pathologist each have a role to play. Only through cooperation among all members of the team will a patient who has metastatic disease or a myeloma be given the best possible care.