Acetabular fracture patterns in the elderly, with increased involvement of the anterior column, quadrilateral plate comminution, medialization of the femoral head, and marginal impaction, differ from those noted among a younger cohort. Poor prognostic factors for open reduction and internal fixation (ORIF) are posterior wall comminution, marginal impaction of the acetabulum, a femoral head impaction fracture, a so-called gull sign, and hip dislocation. The rate of conversion to total hip arthroplasty following formal ORIF has been reported to be 22% at a mean of twenty-nine months. Total hip replacement after an acetabular fracture generally yields good clinical results; however, in the acute setting, it must be combined with proper stable fracture fixation.

The poor prognosis of patients with advanced bone and soft-tissue sarcoma has not changed in the past several decades, highlighting the necessity for new therapeutic approaches. Immunotherapies, including oncolytic viral (OV) therapy, have shown great promise in a number of clinical trials for a variety of tumor types. However, the effective application of OV in treating sarcoma still remains to be demonstrated. Although few pre-clinical studies using distinct OVs have been performed and demonstrated therapeutic benefit in sarcoma models, a side-by-side comparison of clinically relevant OV platforms has not been performed. Four clinically relevant OV platforms (Reovirus, Vaccinia virus, Herpes-simplex virus and Rhabdovirus) were screened for their ability to infect and kill human and canine sarcoma cell lines in vitro, and human sarcoma specimens ex vivo. In vivo treatment efficacy was tested in a murine model. The rhabdovirus MG1 demonstrated the highest potency in vitro. Ex vivo, MG1 productively infected more than 80% of human sarcoma tissues tested, and treatment in vivo led to a significant increase in long-lasting cures in sarcoma-bearing mice. Importantly, MG1 treatment induced the generation of memory immune response that provided protection against a subsequent tumor challenge. This study opens the door for the use of MG1-based oncolytic immunotherapy strategies as treatment for sarcoma or as a component of a combined therapy. Sarcomas are a rare and heterogeneous group of aggressive malignant solid tumors that, unlike carcinomas originating from epithelium, arise from a variety of mesenchymal tissues, such as muscle, connective tissue and bone. Sarcomas require a multimodal therapeutic approach that consists of multiagent chemotherapy, surgical resection and radiation. According to the National Cancer Institute, the overall 5-year survival rate for sarcoma patients is 50%, which drops to <20% for cases involving distant metastatic spread. As such, new treatment options for recurrent/metastatic sarcoma are direly needed.Immunotherapy could provide an alternative to chemotherapy yet there has been little focus on sarcoma in this field. This is likely due to sarcoma's heterogeneous nature and the relatively smaller number of patients it affects compared to carcinomas. However, immune checkpoint inhibitors, which have revolutionized the immunotherapy field and that have been very successful to date in melanoma (e.g., anti-CTLA4, anti-PD-1), have so far failed as monotherapies for sarcoma. 1Oncolytic viruses (OVs) constitute another form of an immunotherapy platform that has showed promising results in a broad range of cancers. OVs are engineered to take advantage of several hallmarks of cancer in order to preferentially replicate in tumor cells. Cancer-selective infection by OVs leads to cancer cell lysis and the parallel production of inflammatory cytokines, leading to innate and adaptive immune responses against both virus and tumor.2 OV treatment can lead to profound anti-tumor immune responses and cure...

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