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Emerging Concepts in the Surgical Management of Peri-Acetabular Metastatic Bone Disease

The pelvis is a common site of metastatic bone disease. Peri-acetabular lesions are particularly challenging and can cause severe pain, disability and pathologic fractures. Surgical management of these lesions has historically consisted of cementoplasty for contained lesions and Harrington reconstru...

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Autores principales: Gazendam, Aaron, Axelrod, Daniel, Wilson, David, Ghert, Michelle
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8293093/
https://www.ncbi.nlm.nih.gov/pubmed/34287325
http://dx.doi.org/10.3390/curroncol28040238
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author Gazendam, Aaron
Axelrod, Daniel
Wilson, David
Ghert, Michelle
author_facet Gazendam, Aaron
Axelrod, Daniel
Wilson, David
Ghert, Michelle
author_sort Gazendam, Aaron
collection PubMed
description The pelvis is a common site of metastatic bone disease. Peri-acetabular lesions are particularly challenging and can cause severe pain, disability and pathologic fractures. Surgical management of these lesions has historically consisted of cementoplasty for contained lesions and Harrington reconstructions for larger, more destructive lesions. Due to the limitations of these procedures, a number of novel procedures have been developed to manage this challenging problem. Percutaneous techniques—including acetabular screw fixation and cementoplasty augmented with screws—have been developed to minimize surgical morbidity. Recent literature has demonstrated a reliable reduction in pain and improvement in function in appropriately selected patients. Several adjuncts to the Harrington procedure have been utilized in recent years to reduce complication rates. The use of constrained liners and dual mobility bearings have reduced the historically high dislocation rates. Cage constructs and porous tantalum implants are becoming increasingly common in the management of large bony defects and destructive lesions. With novel and evolving surgical techniques, surgeons are presented with a variety of surgical options to manage this challenging condition. Physicians must take into account the patients’ overall health status, oncologic prognosis and anatomic location and extent of disease when developing an appropriate surgical plan.
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spelling pubmed-82930932021-07-22 Emerging Concepts in the Surgical Management of Peri-Acetabular Metastatic Bone Disease Gazendam, Aaron Axelrod, Daniel Wilson, David Ghert, Michelle Curr Oncol Commentary The pelvis is a common site of metastatic bone disease. Peri-acetabular lesions are particularly challenging and can cause severe pain, disability and pathologic fractures. Surgical management of these lesions has historically consisted of cementoplasty for contained lesions and Harrington reconstructions for larger, more destructive lesions. Due to the limitations of these procedures, a number of novel procedures have been developed to manage this challenging problem. Percutaneous techniques—including acetabular screw fixation and cementoplasty augmented with screws—have been developed to minimize surgical morbidity. Recent literature has demonstrated a reliable reduction in pain and improvement in function in appropriately selected patients. Several adjuncts to the Harrington procedure have been utilized in recent years to reduce complication rates. The use of constrained liners and dual mobility bearings have reduced the historically high dislocation rates. Cage constructs and porous tantalum implants are becoming increasingly common in the management of large bony defects and destructive lesions. With novel and evolving surgical techniques, surgeons are presented with a variety of surgical options to manage this challenging condition. Physicians must take into account the patients’ overall health status, oncologic prognosis and anatomic location and extent of disease when developing an appropriate surgical plan. MDPI 2021-07-17 /pmc/articles/PMC8293093/ /pubmed/34287325 http://dx.doi.org/10.3390/curroncol28040238 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Commentary
Gazendam, Aaron
Axelrod, Daniel
Wilson, David
Ghert, Michelle
Emerging Concepts in the Surgical Management of Peri-Acetabular Metastatic Bone Disease
title Emerging Concepts in the Surgical Management of Peri-Acetabular Metastatic Bone Disease
title_full Emerging Concepts in the Surgical Management of Peri-Acetabular Metastatic Bone Disease
title_fullStr Emerging Concepts in the Surgical Management of Peri-Acetabular Metastatic Bone Disease
title_full_unstemmed Emerging Concepts in the Surgical Management of Peri-Acetabular Metastatic Bone Disease
title_short Emerging Concepts in the Surgical Management of Peri-Acetabular Metastatic Bone Disease
title_sort emerging concepts in the surgical management of peri-acetabular metastatic bone disease
topic Commentary
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8293093/
https://www.ncbi.nlm.nih.gov/pubmed/34287325
http://dx.doi.org/10.3390/curroncol28040238
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