Safety and Efficacy of Minimally Invasive Acetabular Stabilization for Periacetabular Metastatic Disease with Thermal Ablation and Augmented Screw Fixation

Hartung, Michael; Tutton, Sean; Hohenwalter, Eric J.; King, David M.; Neilson, John C.

doi:10.1016/j.jvir.2016.01.142

Cited by 47 publications

(51 citation statements)

References 21 publications

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“…Although we utilised a simple 4-point scale (due to the retrospective nature of the study) rather than a formal Visual Analogue Scale (VAS), our outcomes are comparable to those of Deschamps et al and Hartung et al [16,17,19].…”

Section: Discussionmentioning

confidence: 87%

“…PIGSF is a novel technique for fracture fixation, which has recently been applied for the treatment of long bone, pelvic, and shoulder-girdle lesions in oncologic patients [16][17][18][19][20]. It offers advantages over conventional surgery including excellent visualisation of surrounding structures to avoid iatrogenic injury, and a rapid post-procedural recovery to minimise onco-therapeutic delay [16][17][18][19].…”

Section: Discussionmentioning

confidence: 99%

“…It offers advantages over conventional surgery including excellent visualisation of surrounding structures to avoid iatrogenic injury, and a rapid post-procedural recovery to minimise onco-therapeutic delay [16][17][18][19]. The technique involves precise placement of co-axial cannulated screws over a guidewire placed perpendicular to the fracture/lesion under imaging guidance, securely anchoring the distal screw in good-quality bone [16][17][18].…”

Section: Discussionmentioning

confidence: 99%

“…The technique involves precise placement of co-axial cannulated screws over a guidewire placed perpendicular to the fracture/lesion under imaging guidance, securely anchoring the distal screw in good-quality bone [16][17][18]. Prior studies have demonstrated technical feasibility, safety, and good short/mid-term outcomes [16,17,19], which appear comparable to surgery [11][12][13].…”

Section: Discussionmentioning

confidence: 99%

“…Several single-centre studies have reported good short-term outcomes and acceptable complication rates for treatment of oncologic bone lesions [16][17][18][19][20]. However, little is known regarding the local evolution of treated lesions on imaging follow-up and associated clinical consequences.…”

Section: Introductionmentioning

confidence: 99%

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Percutaneous Image-Guided Screw Fixation of Bone Lesions in Cancer Patients: Double-Centre Analysis of Outcomes including Local Evolution of the Treated Focus

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Section: Discussionmentioning

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Percutaneous Image-Guided Screw Fixation of Bone Lesions in Cancer Patients: Double-Centre Analysis of Outcomes including Local Evolution of the Treated Focus

Cazzato

Koch

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et al. 2016

Cardiovasc Intervent Radiol

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Pelvis weight‐bearing ability after minimally invasive stabilizations for periacetabular lesion

Lea

Tutton

Alsaikhan

et al. 2020

Journal Orthopaedic Research

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Periacetabular metastatic lesions cause debilitating weight-bearing pain and pose a risk of pelvic pathologic fracture. Minimally invasive percutaneous stabilization is an alternative palliative therapy over extensive open reconstructive surgeries. This study aimed to investigate the biomechanical behaviors of three distinct techniques of percutaneous periacetabular stabilization. A total of 20 composite hemipelves custom-made to contain Harrington type III periacetabular lesion based on a patient's computed tomograpy scans were assigned to treatment groups of cementoplasty alone using polymethyl methacrylate (Cement), screw fixation alone using ischial and posterior-to-anterior screws (Screws), cement-augmented screws (Screws&Cement), and a control group (Untreated). All hemipelves were loaded in a mechanical test configuration mimicking a single-legged stance, and failure load, failure deformation, and construct stiffness were determined. In the experiments, Screws&Cement demonstrated the highest yield strength (4711 ± 362 N) and was 12% higher than Cement (4005 ± 304 N, p = 0.019), 125% higher than Screws (2097 ± 359 N, p < 0.0001), and 184% higher than Untreated (1658 ± 254 N, p < 0.0001). No significant difference in yield strength was found between Screws and Untreated. Screws&Cement also demonstrated the highest stiffness (1013 ± 92 N/mm), followed by Cement (893 ± 49 N/mm), and both groups were significantly stiffer than Screws (543 ± 114 N/mm, p < 0.0001) and Untreated (580 ± 91 N/mm, p < 0.0001 for Screws&Cement, and p = 0.0003 for Cement).This study demonstrated that a cement-augmented periacetabular reconstruction is an effective option for percutaneous treatment of Harrington III periacetabular metastatic lesion. The addition of pelvic screws over cementoplasty significantly improved the pelvis load-bearing strength. When large periacetabular lesions are present, augmented screw fixation appears to be the superior choice of treatment.

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Minimally invasive management of pathologic fractures of the pelvis and sacrum: Tumor ablation and fracture stabilization

Lee

Schutz

Myhre

et al. 2023

Journal of Surgical Oncology

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Background Pathologic fractures of the pelvis/sacrum due to metastatic bone disease (MBD) cause pain and dysfunction due to mechanical instability of the pelvic ring. This study presents our multi‐institutional experience with percutaneous stabilization of pathologic fractures and osteolytic lesions from MBD throughout the pelvic ring. Methods The records of patients undergoing this procedure from 2018 to 2022 were reviewed retrospectively from two institutions. Surgical data and functional outcomes were recorded. Results Fifty‐six patients underwent percutaneous stabilization, with a median operative duration of 119 min (interquartile range [IQR]: 92.8, 167) and median estimated blood loss of 50 mL (IQR: 20, 100). The median length of stay was 3 days (IQR: 1, 6), and 69.6% (n = 39) of patients were discharged home. Early complications included one partial lumbosacral plexus injury, three acute kidney injuries, and one case of intra‐articular cement extravasation. Late complications included two infections and one revision stabilization procedure for hardware failure. Mean Eastern Cooperative Oncology Group (ECOG) scores improved from 3.02 (SD 0.8) preoperatively to 1.86 (SD 1.1) postoperatively (p < 0.001). Ambulatory status also improved (p < 0.001). Conclusions Percutaneous stabilization of pathologic fractures and osteolytic defects of the pelvis and sacrum is a procedure that improves patient function, ambulatory status and is associated with a limited complication profile.

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Safety and Efficacy of Minimally Invasive Acetabular Stabilization for Periacetabular Metastatic Disease with Thermal Ablation and Augmented Screw Fixation

Cited by 47 publications

References 21 publications

Percutaneous Image-Guided Screw Fixation of Bone Lesions in Cancer Patients: Double-Centre Analysis of Outcomes including Local Evolution of the Treated Focus

Percutaneous Image-Guided Screw Fixation of Bone Lesions in Cancer Patients: Double-Centre Analysis of Outcomes including Local Evolution of the Treated Focus

Pelvis weight‐bearing ability after minimally invasive stabilizations for periacetabular lesion

Minimally invasive management of pathologic fractures of the pelvis and sacrum: Tumor ablation and fracture stabilization

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