[Surgical treatment of metastases of the acetabulum]

The lytic metastasis of the acetabulum are frequent, causing pathologic fractures, pain and disability. The authors analyze 42 acetabular metastases operated on between 1976 and 1986. Thirty-nine total hip replacements were made, 9 conventional arthroplasties for minor lesions, and 30 metallo-acrylic reconstructive surgery of the acetabulum combined in 8 cases to bone grafting of more extensive lesions. These arthroplasties allowed immediate weight-bearing. In three cases of very extensive acetabular destructions, hip resections were only possible. The complications were essentially: 3 early deaths, 2 acetabular loosening by tumor osteolysis, and one deep infection. Mean follow-up was 15 months. Results were assessed by pain and walking which are in the whole satisfactory in these patients with limited life expectancy. Surgical indications should be wide in disable patients. It is a palliative surgery aiming to improve the quality of life, giving the patient a functional autonomy.