Symptomatic peri‐acetabular metastatic lesions are often treated with open surgery such as modified Harrington procedures. In an effort to avoid surgical complications inherently associated with open surgical approaches, we developed and recently reported a novel Tripod percutaneous screw technique. The tripod technique is minimally invasive and was found to yield excellent outcomes regarding both pain control and functionality. The procedure is performed in a standard operative theater using fluoroscopic guided percutaneous screws. Despite the simplicity of intraoperative set‐up and instrumentation, it is technically demanding. Obtaining the correct fluoroscopic views and troubleshooting intraoperative hurdles can be challenging for even an experienced orthopedic surgeon. The technique and bony conduits were previously described in the trauma literature, however, there are key points of difference in the setting of metastatic disease. Here we provide a compilation of a stepwise graphic guide for the tripod model in the setting of metastatic peri‐acetabular lesions, as well as the tips and tricks based on our own experience. These encompass preoperative preparation, operating room settings, intraoperative fluoroscopic guidance, postoperative care, and subsequent conversion to a cemented total hip arthroplasty, if needed.

No abstract

Objective: The primary objective of this study is to assess whether the degree of religiosity or certain moral teachings are associated with dyspareunia. Methods: A cross-sectional survey with 24 questions was designed that incorporated the previously validated Duke Religiosity Index questionnaire, medical and sexual history, and demographic information. The index measures organizational, non-organizational, and intrinsic religiosity. Participants were recruited from Ob/Gyn and Family Medicine clinics and from a large university in our community. Results: A total of 901 surveys were included in final analysis. Among our study population, the prevalence of dyspareunia was 19.4%. Participants were categorized by the presence or absence of the primary outcome, dyspareunia. There were no differences in the scores of organized religiosity, p = 0.73 (2.98 ± 0.47 vs 3.04 ± 1.55), non-organized religiosity, p = 0.57 (2.62 ± 1.71 vs 2.82 ± 1.82), or intrinsic religiosity p = 0.64 (10.53 ± 3.63 vs 10.47 ± 4.06) in women with and without dyspareunia, respectively. No associations were found between dyspareunia and a participant’s current or childhood religious affiliation. However, women who were taught “sex is bad” while growing up had a higher rate of dyspareunia compared to those who were not taught this belief, (27.0% vs 15.3%, p < 0.001). Similar results were found in women who were taught to “wait until marriage to have sex”; 21.6% experienced dyspareunia while only 13.2% of those who were not taught to wait experienced dyspareunia (p = 0.005). Conclusions: While degree of religiosity was not shown to be associated with dyspareunia, women who learned certain restrictive sexual values were at higher risk of experiencing painful intercourse.