To evaluate
mini
mally invasive acetabular stabilization (MIAS) with ther
mal ablation and aug
mented screw fixation for i
mpending or
mini
mally displaced fractures of the acetabulu
m 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 (m>Pm> < .05). The mean MSTS pain scores improved from 0% (all) to 32% ± 22 after MIAS (m>Pm> < .05). The mean MSTS walking ability score improved from 22% ± 19 to 55% ± 26 after MIAS (m>Pm> < .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.