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Emerging Minimally Invasive Percutaneous Procedures for Periacetabular Osteolytic Metastases

Journal

JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME
Volume 105, Issue 6, Pages 479-489

Publisher

LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.2106/JBJS.22.00694

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Periacetabular osteolytic skeletal metastases are often associated with pain and impaired ambulatory function. Minimally invasive percutaneous procedures have become popular for managing these metastases, including cancer ablation and reinforcement techniques.
Periacetabular osteolytic skeletal metastases are frequently associated with pain and impaired ambulatory function. Minimally invasive techniques allow for the restoration of ambulation without interrupting critical systemic cancer therapy. The open surgical management of massive periacetabular osteolytic lesions, such as by curettage, internal fixation, or complex total hip reconstruction, is associated with blood loss, hospitalization, rehabilitation, and complications such as infection or delayed wound-healing. Minimally invasive percutaneous procedures have become increasingly popular for the management of periacetabular osteolytic metastases by interventional oncologists and orthopaedic surgeons before complex open surgical procedures are considered. Minimally invasive procedures may include various methods of cancer ablation and reinforcement techniques. Minimally invasive procedures may entail cancer ablation, polymethylmethacrylate (PMMA) cement reinforcement, balloon osteoplasty, percutaneous screw fixation, or combinations of the aforementioned techniques (e.g., ablation-osteoplasty-reinforcement-internal fixation [AORIF]).

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