我们之前报道过使用 LUMiC 假体进行髋臼周围肿瘤重建的有希望的早期结果。目前的研究评估了多中心队列中的中期并发症、翻修率、种植体翻修的累积发生率以及并发症的危险因素。我们评估了 P1b 2、P2、P2 3 或 P1b 2 3 型后出现肿瘤缺损的患者2008 年至 2022 年期间，使用 LUMiC 假体重建半骨盆内切除术。根据 Henderson 分类报告并发症。使用竞争风险模型来估计因机械和非机械原因而进行的种植体翻修的累积发生率以及因任何并发症而进行的再次手术。 Cox模型用于研究危险因素对脱位和感染的影响。纳入了166名患者（中位随访时间，4.2年[四分位距，2.6至7.6年]）。共有 114 例 (69%) 因原发性恶性肿瘤接受治疗，46 例 (28%) 因转移性癌接受治疗，5 例 (3%) 因良性侵袭性病变接受治疗，1 例 (1%) 因其他原因接受治疗。 82 名患者 (49%) 进行了 165 次再次手术； 104 例（63%）的再手术是在 6 个月内进行的。 166 颗植入物中的 32 颗 (19%) 进行了修整：13 颗 (8%) 出于机械原因，主要是脱位（n = 5, 3%），19 颗 (11%) 出于非机械原因，主要是假体周围关节感染 (PJI) (n = 15, 9%)。第 2 年、第 5 年和第 10 年因机械原因和 PJI（Henderson 1 至 4）而进行翻修的累积发生率分别为 11%（95% 置信区间 [CI]，7% 至 17%）、18%（12% 至 25 %）和 24%（16% 至 33%）。先前在同一部位进行的手术与脱位风险增加相关（特定原因风险比 [HRCS]，3.0 [95% CI，1.5 至 6.4]；p < 0.01），而涉及 P3 区域的切除则与脱位风险增加相关。感染风险（HRCS，2.5 [95% CI，1.4 至 4.7]；p < 0.01）。尽管存在很大的再手术风险，但 LUMiC 假体在中期证明了其耐用性，机械翻修率较低，大多数患者仍保留其功能主要植入物。大多数并发症发生在术后最初几个月。之前在同一部位接受过手术的患者脱臼风险增加，可能会受益于更保守的康复和术后护理。措施应旨在降低 PJI 风险，特别是涉及 P3 区域的切除术。治疗级别 IV。有关证据级别的完整说明，请参阅作者须知。版权所有 © 2024 作者。由《骨与关节外科杂志》公司出版。

We previously reported promising early results for periacetabular tumor reconstructions using the LUMiC prosthesis. The current study evaluates mid-term complications, revision rates, cumulative incidence of implant revision, and risk factors for complications in a multicenter cohort.We assessed patients in whom a tumor defect after type P1b+2, P2, P2+3, or P1b+2+3 internal hemipelvectomy was reconstructed with a LUMiC prosthesis during the period of 2008 to 2022. Complications were reported according to the Henderson classification. Competing risks models were used to estimate the cumulative incidence of implant revision for mechanical and nonmechanical reasons, and reoperations for any complication. Cox models were used to study the effect of risk factors on dislocation and infection.One hundred and sixty-six patients (median follow-up, 4.2 years [interquartile range, 2.6 to 7.6 years]) were included. A total of 114 (69%) were treated for a primary malignant tumor, 46 (28%) for metastatic carcinoma, 5 (3%) for a benign aggressive lesion, and 1 (1%) for another reason. One hundred and sixty-five reoperations were performed in 82 (49%) of the patients; 104 (63%) of the reoperations were within 6 months. Thirty-two (19%) of 166 implants were revised: 13 (8%) for mechanical reasons, mainly dislocation (n = 5, 3%), and 19 (11%) for nonmechanical reasons, mainly periprosthetic joint infection (PJI) (n = 15, 9%). The cumulative incidences of revision for mechanical reasons and PJI (Henderson 1 to 4) at 2, 5, and 10 years were 11% (95% confidence interval [CI], 7% to 17%), 18% (12% to 25%), and 24% (16% to 33%), respectively. Previous surgery at the same site was associated with an increased dislocation risk (cause-specific hazard ratio [HRCS], 3.0 [95% CI, 1.5 to 6.4]; p < 0.01), and resections involving the P3 region were associated with an increased infection risk (HRCS, 2.5 [95% CI, 1.4 to 4.7]; p < 0.01).Despite a substantial reoperation risk, the LUMiC prosthesis demonstrated its durability in the mid-term, with a low mechanical revision rate and most patients retaining their primary implant. Most complications occur in the first postoperative months. Patients with previous surgery at the same site had an increased dislocation risk and might benefit from more conservative rehabilitation and aftercare. Measures should be aimed at reducing the PJI risk, especially in resections involving the P3 region.Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.Copyright © 2024 The Authors. Published by The Journal of Bone and Joint Surgery, Incorporated.