Palliative surgery for acetabular metastasis with pathological central dislocation of the hip joint after radiation therapy: a case report.
Orthopedic surgery for bone metastases is mainly a palliative treatment. Pathological central dislocation of the hip joint secondary to osteonecrosis of acetabular metastasis after radiation therapy brings severe suffering to cancer patients. We performed minimally invasive palliative surgery for an elderly woman, and excellent pain relief was achieved. An 80-year-old female suffering from right hip pain was referred to our hospital. She had undergone surgery for lung cancer 5 years previously and her right acetabulum was subsequently affected by metastasis. With the aim of controlling the metastasis, radiation therapy was performed. Two years later, pathological central dislocation of the hip joint occurred with sudden onset of severe pain, and she was unable to maintain a sitting position and became bedridden. After she was referred to our hospital, we created an intentional pseudarthrosis in the femoral neck for palliation. After the surgery, excellent pain relief and remarkably improved mobility were achieved during her limited remaining lifetime. In this report, we introduce a novel method of producing a pseudarthrosis in the femoral neck for pathological dislocation. This procedure is a minimally invasive treatment and an alternative option for palliative surgery for pathological dislocation of the hip joint due to osteonecrosis after radiation therapy.
Department of Orthopedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan. hoshi@med.osaka-cu.ac.jp
Manabu
M
Hoshi
Susumu
S
Taguchi
Jun
J
Takada
Naoto
N
Oebisu
Hiroaki
H
Nakamura
Masatsugu
M
Takami
D000077:Acetabulum; D000230:Adenocarcinoma / Q000473:pathology / Q000556:secondary*; D000077192:Adenocarcinoma of Lung; D000369:Aged, 80 and over; D001859:Bone Neoplasms / Q000532:radiotherapy / Q000556:secondary* / Q000601:surgery*; D005260:Female; D006617:Hip Dislocation; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology / Q000556:secondary*; D019637:Orthopedic Procedures; D010020:Osteonecrosis / Q000150:complications; D010166:Palliative Care