title: Percutaneous acetabuloplasty for metastatic acetabular lesions.
abstract: 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.
authors.affiliation: Department of Orthopaedics and Traumatology Catholic University, Agostino Gemelli Hospital - Rome, Italy. giuliomac@tiscali.it
authors.forename: Giulio
authors.initials: G
authors.lastname: Maccauro
authors.forename: Francesco
authors.initials: F
authors.lastname: Liuzza
authors.forename: Laura
authors.initials: L
authors.lastname: Scaramuzzo
authors.forename: Alessandro
authors.initials: A
authors.lastname: Milani
authors.forename: Francesco
authors.initials: F
authors.lastname: Muratori
authors.forename: Barbara
authors.initials: B
authors.lastname: Rossi
authors.forename: Victor
authors.initials: V
authors.lastname: Waide
authors.forename: Giandomenico
authors.initials: G
authors.lastname: Logroscino
authors.forename: Carlo A
authors.initials: CA
authors.lastname: Logroscino
authors.forename: Nicola
authors.initials: N
authors.lastname: Maffulli
mesh_terms: 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