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Ablation-First Balloon-Assisted Acetabuloplasty for Painful Acetabular Metastases: Clinical Outcomes and Mechanical
Claudio Pusceddu1, Eliodoro Faiella2, Pierluigi Maria Rinaldi1
1Radiology, Mater Olbia Hospital, SS 125 Orientale Sarda, 07026 Olbia, Italy.
Current Oncology (Toronto, Ont.)
|April 27, 2026
Summary
This study shows that a two-step thermal ablation followed by Balloon-Assisted Acetabuloplasty (BAA) is a safe and effective treatment for acetabular metastases. The procedure significantly reduces pain and improves mobility, allowing patients to transition to radiotherapy.
Area of Science:
- Orthopedic Oncology
- Interventional Radiology
- Musculoskeletal Oncology
Background:
- Acetabular metastases often cause severe pain and mobility impairment.
- Current treatments may not provide immediate pain relief or mechanical stabilization.
- A novel approach is needed to manage these debilitating symptoms.
Purpose of the Study:
- To assess the safety and efficacy of a two-step protocol for acetabular metastases.
- To evaluate CT/fluoroscopic-guided thermal ablation followed by Balloon-Assisted Acetabuloplasty (BAA).
- To determine the procedure's role as a bridge to radiotherapy.
Main Methods:
- Retrospective analysis of 16 patients with painful acetabular metastases (VAS ≥ 6).
- Sequential protocol: 1. Thermal ablation (radiofrequency/microwave), 2. Balloon-Assisted Acetabuloplasty (BAA) with PMMA cement.
- Outcomes measured: Visual Analog Scale (VAS) for pain, Functional Mobility Scale (FMS).
Main Results:
- 100% technical success with a mean procedural time of 58 minutes.
- No major complications reported; all patients alive at mean 8.2 months follow-up.
- Significant pain reduction (VAS 7.4 to 0.9 at 1 month, p < 0.001) and improved mobility (FMS 2.9 to 1.1 at 1 month, p < 0.001).
- 87.5% of patients regained independent ambulation.
Conclusions:
- The "ablation-first" BAA strategy is safe and highly effective for acetabular metastases.
- Immediate pain relief and restoration of biomechanical stability are achieved.
- Facilitates rapid patient mobilization and seamless transition to radiotherapy.
