Percutaneous Acetabuloplasty Compared With Open Reconstruction for Extensive Periacetabular Carcinoma Metastases

Colman, Matthew W.; Karim, Syed M.; Hirsch, Joshua A; Yoo, Albert J.; Schwab, Joseph H.; Hornicek, Francis J.; Raskin, Kevin A.

doi:10.1016/j.arth.2015.02.022

Cited by 15 publications

(8 citation statements)

References 18 publications

(40 reference statements)

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“…In the literature, implant survival is rarely reported, but reported implant failure rates leading to revision surgery vary between 3% and 18%. Revisions are needed due to fractured rods, constant or repeated dislocations, and mechanical and technical errors similar to our case (Allan et al 1995, Marco et al 2000, Bernthal et al 2015, Colman et al 2015. Complications after surgery vary considerably, with 11% in our study and published reports ranging from 16% to 33% (Nilsson et al 2000, Shahid et al 2014, Tsagozis et al 2015, Charles et al 2017, Krishnan et al 2017.…”

Section: Discussionsupporting

confidence: 62%

Modified Harrington’s procedure for periacetabular metastases in 89 cases: a reliable method for cancer patients with good functional outcome, especially with long expected survival

et al. 2020

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Background and purpose — The pelvis is the 3rd most common site of skeletal metastases. In some cases, periacetabular lesions require palliative surgical management. We investigated functional outcome, complications, and implant and patient survival after a modified Harrington’s procedure. Patients and methods — This retrospective cohort study included 89 cases of surgically treated periacetabular metastases. All patients were treated with the modified Harrington’s procedure including a restoration ring. Lesions were classified according to Harrington. Functional outcome was assessed by Harris Hip Score (HHS) and Oxford Hip Score (OHS). Postoperative complications, and implant and patient survival are reported. Results — The overall postoperative functional outcome was good to fair (OHS 37 and HHS 76). Sex, age, survival > 6 and 12 months, and diagnosis of the primary tumor affected functional outcome. Overall implant survival was 96% (95% Cl 88–100) at 1 year, 2 years, and 5 years; only 1 acetabular implant required revision. Median patient survival was 8 months (0–125). 10/89 patients had postoperative complications: 6 major complications, leading to revision surgery, and 4 minor complications. Interpretation — Our modified Harrington’s procedure with a restoration ring to achieve stable fixation, constrained acetabular cup to prevent dislocation, and antegrade iliac screws to prevent cranial protrusion is a reliable reconstruction for periacetabular metastases and results in a good functional outcome in patients with prolonged survival. A standardized procedure and low complication rate encourage the use of this method for all Harrington class defects.

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Section: Discussionsupporting

confidence: 62%

Modified Harrington’s procedure for periacetabular metastases in 89 cases: a reliable method for cancer patients with good functional outcome, especially with long expected survival

et al. 2020

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“…Surgery may entail a simple excision arthroplasty in patients with very poor general condition or terminal disease. Cementoplasty may be considered in constrained, relatively small lytic periacetabular lesions without any displaced pathological fracture[ 40 , 41 ]. In relatively small defects that are not contained, and extend to the hip joint, curettage and a cemented total hip arthroplasty are sufficient.…”

Section: Methods and Outcome Of Surgical Treatmentmentioning

confidence: 99%

Current concepts in the surgical treatment of skeletal metastases

Ehne

Tsagozis

2020

WJO

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Symptomatic metastatic bone disease affects a large proportion of patients with malignant tumours and significantly impairs patients’ quality of life. There are still controversies regarding both surgical indications and methods, mainly because of the relatively few high-quality studies in this field. Generally, prosthetic reconstruction has been shown to result in fewer implant failures and should be preferred in patients with a good prognosis. Survival estimation tools should be used as part of preoperative planning. Adjuvant treatment, which relies on radiotherapy and inhibition of osteoclast function may also offer symptomatic relief and prevent implant failure. In this review we discuss the epidemiology, indications for surgery, preoperative planning, surgical techniques and adjuvant treatment of metastatic bone disease.

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“…We did not notice that patients’ general condition significantly improved after the treatment (Table 2), not the same as Maccauro and Colman reported. [17,20] It is understandable, because 25 patients (78.1%) in this study had multiple bone lesions (6 of 25 with concomitant visceral involvement), obviously, the general condition of our patients was poorer and 9 patients received further operations for other bone metastases. Therefore, the general condition improvement evaluated by ECOG index was not significant.…”

Section: Discussionmentioning

confidence: 77%

Improving functional outcome and quality of life for patients with metastatic lesion of acetabulum undergoing cement augmentation

et al. 2019

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There is an increased enthusiasm in treating osteolytic metastatic acetabulum via injecting polymethyl-methacrylate (PMMA) as a bone filler to provide pain relief and potential structural support. The aim of this respective study is to determine the function and quality of life improvement after cement acetabuloplasty.Thirty two patients underwent acetabular cement augmentation between May 2014 and March 2018 were respectively reviewed. Isolated percutaneous acetabuloplasty (PA) was performed in 15 patients (group A) while radiofrequency ablation with PA (RFA-PA) in 12 patients (group B). Together with PA, open reconstructive surgery on ipsilateral femur was performed in another 5 cases (group C). Pre- and posttreatment functional evaluation and quality of life (QoL) assessment were carried out.The average followup duration was 11.5 (range, 3–36) months. None of major complications occurred. 81.2% (26/32) of patients achieved complete pain relief. Reduction of pain intensity and improvement of functional status achieved significantly differences after treatment (P = .00). Significant improvement (P = .00) was observed in scales of global QoL and pain-related restrictions in daily activities. Both isolated PA and RFA-PA procedures were equally effective towards the improvement of function and quality of life (P > .05). Regarding 5 patients in group C, pain intensity decreased when loading the affected limb and they could walk with crutches or cane.Bone cement acetabuloplasty is an adequate and effective mini-invasive procedure to relieve pain, restore function, and enhance the quality of life of patients for as long as possible in metastatic patients with short life expectancy. Ipsilateral surgery appears to be safe and well tolerated.

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Percutaneous Acetabuloplasty Compared With Open Reconstruction for Extensive Periacetabular Carcinoma Metastases

Cited by 15 publications

References 18 publications

Modified Harrington’s procedure for periacetabular metastases in 89 cases: a reliable method for cancer patients with good functional outcome, especially with long expected survival

Modified Harrington’s procedure for periacetabular metastases in 89 cases: a reliable method for cancer patients with good functional outcome, especially with long expected survival

Current concepts in the surgical treatment of skeletal metastases

Improving functional outcome and quality of life for patients with metastatic lesion of acetabulum undergoing cement augmentation

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