title: Percutaneous Acetabuloplasty Compared With Open Reconstruction for Extensive Periacetabular Carcinoma Metastases.
abstract: For destructive metastatic periacetabular disease, options include open acetabular reconstruction or percutaneous cement acetabuloplasty (PA). We reviewed 28 consecutive patients with Harrington grade II or III lesions, 17 who underwent Harrington-type or anti-protrusio reconstruction and 11 who underwent PA. Primary outcome measures were performance status (PS), ambulatory status (0=unassisted ambulation, 1=assisted ambulation, 2=nonambulatory), and 10-point VAS score. The surgery group had better pain reduction than the PA group at 3 months (3.6 vs. 1.5 points, P=0.04), and a trend at final follow-up (3.8 vs. 1.4 points, P=0.06). Improvement in ambulatory status was better in the surgery group at 3 months only (0.53 vs. -0.14, P=0.03). Thus compared with PA, open reconstruction may provide improved pain relief and ambulation.
authors.affiliation: Rush University/Midwest Orthopedics, Chicago, Illinois.
authors.forename: Matthew W
authors.initials: MW
authors.lastname: Colman
authors.affiliation: Massachusetts General Hospital, Harvard Combined Department of Orthopedics, Boston, Massachusetts.
authors.forename: Syed M
authors.initials: SM
authors.lastname: Karim
authors.affiliation: Massachusetts General Hospital, Department of Neuroradiology, Boston, Massachusetts.
authors.forename: Joshua A
authors.initials: JA
authors.lastname: Hirsch
authors.affiliation: Massachusetts General Hospital, Department of Neuroradiology, Boston, Massachusetts.
authors.forename: Albert J
authors.initials: AJ
authors.lastname: Yoo
authors.affiliation: Massachusetts General Hospital, Harvard Combined Department of Orthopedics, Boston, Massachusetts.
authors.forename: Joseph H
authors.initials: JH
authors.lastname: Schwab
authors.affiliation: Massachusetts General Hospital, Harvard Combined Department of Orthopedics, Boston, Massachusetts.
authors.forename: Francis J
authors.initials: FJ
authors.lastname: Hornicek
authors.affiliation: Massachusetts General Hospital, Harvard Combined Department of Orthopedics, Boston, Massachusetts.
authors.forename: Kevin A
authors.initials: KA
authors.lastname: Raskin
mesh_terms: D065526:Acetabuloplasty / Q000379:methods*; D000077:Acetabulum / Q000601:surgery; D000368:Aged; D001843:Bone Cements; D001859:Bone Neoplasms / Q000601:surgery*; D002277:Carcinoma / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D009362:Neoplasm Metastasis; D012086:Reoperation; D012189:Retrospective Studies; D013514:Surgical Procedures, Operative; D016896:Treatment Outcome; D016138:Walking
chemical_list: D001843:Bone Cements
keywords: Harrington reconstruction; acetabuloplasty; carcinoma; cement; metastasis; periacetabular