Ablation, Osteoplasty, Reinforcement, and Internal Fixation Allows for Subsequent Hip Arthroplasty Reconstruction

A 34-year-old woman with stage IV breast cancer presented with bilateral acetabular metastases, a right pathological femoral fracture, and a left subtrochanteric impending fracture. Imaging confirmed extensive metastatic disease of bone. A staged approach included prophylactic femoral nailing of the left femur, ablation, osteoplasty, reinforcement, and internal fixation (AORIF) of both acetabula, followed with a right hybrid arthroplasty and prophylactic fixation of the right femur. She regained independent ambulation, remained pain-free, and continued systemic therapy after 1 year.

AORIF provided rapid pain relief and increased mechanical resistance, allowing a successful secondary arthroplasty with standard implants, demonstrating its value as a minimally invasive option in periacetabular metastatic bone disease.