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Minimally Invasive Stabilization with or without Ablation for Metastatic Periacetabular Tumors.

D Ian English¹, William B Lea², David M King²

¹Department of Orthopedic Surgery, University of Texas Health Science Center at Houston, Houston, Texas.

The Journal of Bone and Joint Surgery. American Volume

|May 26, 2021

Summary

Minimally invasive osteoplasty and screw fixation effectively relieve pain and improve function in patients with periacetabular metastatic bone disease, with minimal complications and reduced narcotic use.

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Area of Science:

Orthopedic Oncology
Surgical Oncology
Musculoskeletal Oncology

Background:

Periacetabular metastatic bone disease poses significant challenges to patient pain and function.
Surgical intervention is crucial for pain relief and functional restoration in these cases.

Purpose of the Study:

To evaluate the efficacy of minimally invasive osteoplasty and screw fixation for periacetabular metastatic disease.
To assess functional outcomes and changes in narcotic usage post-surgery.

Main Methods:

Retrospective review of 38 patients with diverse metastatic tumor subtypes treated with osteoplasty and screw fixation.
Functional outcomes assessed using the 1993 Musculoskeletal Tumor Society (MSTS) score.
Narcotic usage changes were analyzed.

Main Results:

All patients experienced improved MSTS scores post-surgery.
Over 80% of patients showed a decrease in narcotic usage.
Complications were minimal, with no delays in adjuvant therapies and no surgery-related deaths.

Conclusions:

Minimally invasive stabilization offers pain relief and functional improvement for periacetabular metastatic disease with lower complication rates than open techniques.
This approach facilitates prompt initiation of chemotherapy and radiation.
While effective, aggressive cancers may necessitate further procedures; however, prior fixation provides a stable base for subsequent reconstructions like total hip arthroplasty.