Percutaneous acetabuloplasty for metastatic acetabular lesions.
BACKGROUND
Osteolytic metastases around the acetabulum are frequent in tumour patients, and may cause intense and drug-resistant pain of the hip. These lesions also cause structural weakening of the pelvis, limping, and poor quality of life. Percutaneous acetabuloplasty is a mini-invasive procedure for the management of metastatic lesions due to carcinoma of the acetabulum performed in patients who cannot tolerate major surgery, or in patients towards whom radiotherapy had already proved ineffective.


METHODS
We report a retrospective study in 25 such patients (30 acetabuli) who were evaluated before and after percutaneous acetabuloplasty, with regard to pain, mobility of the hip joint, use of analgesics, by means of evaluation forms: Visual Analog Scale, Harris Hip Score, Western Ontario and McMaster Universities Index of Osteoarthritis (WOMAC), Eastern Cooperative Oncology Group (ECOG). The results obtained were analysed using the chi2 Test and Fisher's exact test. Significance was sent at P < 0.05.


RESULTS
Marked clinical improvement was observed in all patients during the first six post-operative months, with gradual a worsening thereafter from deterioration of their general condition. Complete pain relief was achieved in 15 of our 25 (59%) of patients, and pain reduction was achieved in the remaining 10 (41%) patients. The mean duration of pain relief was 7.3 months. Pain recurred in three patients (12%) between 2 weeks to 3 months. No major complications occurred. There was transient local pain in most cases, and 2 cases of venous injection of cement without clinical consequences.


CONCLUSIONS
Percutaneous acetabuloplasty is effective in improving the quality of life of patients with osteolytic bone tumours, even though the improvement is observed during the first 6 months only. It can be an effective aid to chemo- and radiotherapy in the management of acetabular metastases.
Maccauro
Giulio
G
Department of Orthopaedics and Traumatology Catholic University, Agostino Gemelli Hospital - Rome, Italy. giuliomac@tiscali.it
Liuzza
Francesco
F
Scaramuzzo
Laura
L
Milani
Alessandro
A
Muratori
Francesco
F
Rossi
Barbara
B
Waide
Victor
V
Logroscino
Giandomenico
G
Logroscino
Carlo A
CA
Maffulli
Nicola
N
D000077:Acetabulum / Q000000981:diagnostic imaging / Q000601:surgery*; D001859:Bone Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary* / Q000601:surgery*; D001943:Breast Neoplasms / Q000150:complications / Q000000981:diagnostic imaging; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement / Q000379:methods; D011471:Prostatic Neoplasms / Q000150:complications / Q000000981:diagnostic imaging; D011859:Radiography; D012189:Retrospective Studies