Faculty Collaboration Database

Safety and Efficacy of Minimally Invasive Acetabular Stabilization for Periacetabular Metastatic Disease with Thermal Ablation and Augmented Screw Fixation. J Vasc Interv Radiol 2016 May;27(5):682-688.e1

Date

04/05/2016

Pubmed ID

27040937

DOI

10.1016/j.jvir.2016.01.142

Scopus ID

2-s2.0-84961943220 (requires institutional sign-in at Scopus site)   41 Citations

Abstract

PURPOSE: To evaluate minimally invasive acetabular stabilization (MIAS) with thermal ablation and augmented screw fixation for impending or minimally displaced fractures of the acetabulum secondary to metastatic disease.

MATERIALS AND METHODS: Between February 2011 and July 2014, 13 consecutive patients underwent thermal ablation, percutaneous screw fixation, and polymethyl methacrylate augmentation for impending or nondisplaced fractures of the acetabulum secondary to metastatic disease. Functional outcomes were evaluated before and after the procedure using the Musculoskeletal Tumor Society (MSTS) scoring system. Complications, hospital length of stay, and eligibility for chemotherapy and radiation therapy were assessed.

RESULTS: All procedures were technically successful with no major periprocedural complications. The mean total MSTS score improved from 23% ± 11 before MIAS to 51% ± 21 after MIAS (P < .05). The mean MSTS pain scores improved from 0% (all) to 32% ± 22 after MIAS (P < .05). The mean MSTS walking ability score improved from 22% ± 19 to 55% ± 26 after MIAS (P < .05). Two complications occurred; a patient had a minimally displaced fracture of the superior pubic ramus at the site of repair but remained ambulatory, and septic arthritis was diagnosed in another patient 12 months after repair. The average length of hospital stay was 2 days ± 3.6; six patients were discharged within 24 hours of the procedure. All patients were eligible for chemotherapy and radiation therapy immediately after the procedure.

CONCLUSIONS: MIAS is feasible, improves pain and mobility, and offers a minimally invasive alternative to open surgical reconstruction.

Author List

Hartung MP, Tutton SM, Hohenwalter EJ, King DM, Neilson JC

Authors

Eric J. Hohenwalter MD, FSIR Chief, Professor in the Radiology department at Medical College of Wisconsin
David M. King MD Chair, Professor in the Orthopaedic Surgery department at Medical College of Wisconsin
John C. Neilson MD Associate Professor in the Orthopaedic Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Ablation Techniques
Acetabulum
Adult
Aged
Aged, 80 and over
Biomechanical Phenomena
Bone Cements
Bone Neoplasms
Bone Screws
Chemotherapy, Adjuvant
Female
Fracture Fixation, Internal
Fracture Healing
Fractures, Spontaneous
Humans
Length of Stay
Male
Middle Aged
Polymethyl Methacrylate
Radiotherapy, Adjuvant
Recovery of Function
Retrospective Studies
Time Factors
Tomography, X-Ray Computed
Treatment Outcome