title: Metastatic disease around the hip: maintaining quality of life.
abstract: Many tumors metastasise to bone, therefore, pathologic   fracture and impending pathologic fractures are common reasons for   orthopedic consultation. Having effective treatment strategies is   important to avoid complications, and relieve pain and preserve   function. Thorough pre-operative evaluation is recommended for medical   optimization and to ensure that the lesion is in fact a metastasis   and not a primary bone malignancy. For impending fractures, various scoring   systems have been proposed to determine the risk of fracture, and   therefore the need for prophylactic stabilisation. Lower score lesions   can often be treated with radiation, while more problematic lesions   may require internal fixation. Intramedullary fixation is generally   preferred due to favorable biomechanics. Arthroplasty may be required   for lesions with massive bony destruction where internal fixation   attempts are likely to fail. Radiation may also be useful postoperatively   to minimise construct failure due to tumor progression.
authors.affiliation: Level One Orthopaedics, Orlando, Florida 32806, United States. docgjh@aol.com
authors.forename: G J
authors.initials: GJ
authors.lastname: Haidukewych
mesh_terms: D000077:Acetabulum / Q000473:pathology / Q000601:surgery; D019644:Arthroplasty, Replacement, Hip; D001859:Bone Neoplasms / Q000150:complications / Q000175:diagnosis / Q000556:secondary* / Q000628:therapy; D005594:Fracture Fixation, Intramedullary; D006620:Hip Fractures / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control / Q000601:surgery; D006621:Hip Joint / Q000473:pathology / Q000601:surgery; D006801:Humans; D011300:Preoperative Care; D011788:Quality of Life; D018714:Radiotherapy, Adjuvant; D018570:Risk Assessment