title: Balloon-assisted osteoplasty of periacetabular tumors following percutaneous cryoablation.
abstract: OBJECTIVE
  To describe the feasibility, safety, and effectiveness of a technique using vertebral augmentation balloons to promote delivery of cement into periacetabular tumors after cryoablation for fracture prevention.
  
  
  METHODS
  A retrospective review was performed of seven consecutive patients (six men and one woman; mean age, 64 y ± 8) with unilateral periacetabular tumors (mean size, 4.2 cm ± 1.4) treated with cryoablation and balloon-assisted osteoplasty for fracture prevention. Cortical defects were seen in six (86%) tumors, and additional pathologic fractures occurred in five (71%) tumors before treatment. The cohort included six (86%) Harrington class I defects and one (14%) class II defect. Procedures were performed with computed tomography fluoroscopic guidance and general anesthesia. Vertebral augmentation balloons (mean, 2; range, 1-4) were inflated within the ablation cavity immediately before or during cement injection.
  
  
  RESULTS
  All procedures were technically successful. Median percentage tumor fill was 63% (range, 17%-96%). Minor cement leakage occurred in two (29%) patients with no symptomatic or intraarticular extravasation. A new nondisplaced fracture occurred in one patient and was conservatively managed. No major complications occurred. Local tumor progression occurred in one (20%) of five patients with imaging follow-up.
  
  
  CONCLUSIONS
  Balloon-assisted osteoplasty after cryoablation of periacetabular tumors appears feasible, safe, and effective for fracture prevention. This technique directs cement instillation into ablation defects with a high degree of filling and minimal leakage.
authors: Department of Radiology, Mayo Clinic, 200 1st Street SW, Rochester, MN, 55905.. Electronic address: kurup.anil@mayo.edu.
authors: A Nicholas
authors: AN
authors: Kurup
authors: Department of Radiology, Mayo Clinic, 200 1st Street SW, Rochester, MN, 55905.; Department of Orthopedic Surgery, Mayo Clinic, 200 1st Street SW, Rochester, MN 55905.
authors: Jonathan M
authors: JM
authors: Morris
authors: Department of Radiology, Mayo Clinic, 200 1st Street SW, Rochester, MN, 55905.
authors: Grant D
authors: GD
authors: Schmit
authors: Department of Radiology, Mayo Clinic, 200 1st Street SW, Rochester, MN, 55905.
authors: Thomas D
authors: TD
authors: Atwell
authors: Department of Radiology, Mayo Clinic, 200 1st Street SW, Rochester, MN, 55905.
authors: John J
authors: JJ
authors: Schmitz
authors: Department of Orthopedic Surgery, Mayo Clinic, 200 1st Street SW, Rochester, MN 55905.
authors: Peter S
authors: PS
authors: Rose
authors: Department of Radiology, Mayo Clinic, 200 1st Street SW, Rochester, MN, 55905.
authors: Matthew R
authors: MR
authors: Callstrom
mesh_terms: D000077:Acetabulum / Q000601:surgery*; D000368:Aged; D001843:Bone Cements / Q000627:therapeutic use*; D001859:Bone Neoplasms / Q000000981:diagnostic imaging* / Q000628:therapy*; D060826:Cementoplasty / Q000379:methods*; D003131:Combined Modality Therapy / Q000379:methods; D003452:Cryosurgery / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D001843:Bone Cements