title: Safety and Efficacy of Minimally Invasive Acetabular Stabilization for Periacetabular Metastatic Disease with Thermal Ablation and Augmented Screw Fixation.
abstract: OBJECTIVE
  To evaluate minimally invasive acetabular stabilization (MIAS) with thermal ablation and augmented screw fixation for impending or minimally displaced fractures of the acetabulum secondary to metastatic disease.
  
  
  METHODS
  Between February 2011 and July 2014, 13 consecutive patients underwent thermal ablation, percutaneous screw fixation, and polymethyl methacrylate augmentation for impending or nondisplaced fractures of the acetabulum secondary to metastatic disease. Functional outcomes were evaluated before and after the procedure using the Musculoskeletal Tumor Society (MSTS) scoring system. Complications, hospital length of stay, and eligibility for chemotherapy and radiation therapy were assessed.
  
  
  RESULTS
  All procedures were technically successful with no major periprocedural complications. The mean total MSTS score improved from 23% ± 11 before MIAS to 51% ± 21 after MIAS (P < .05). The mean MSTS pain scores improved from 0% (all) to 32% ± 22 after MIAS (P < .05). The mean MSTS walking ability score improved from 22% ± 19 to 55% ± 26 after MIAS (P < .05). Two complications occurred; a patient had a minimally displaced fracture of the superior pubic ramus at the site of repair but remained ambulatory, and septic arthritis was diagnosed in another patient 12 months after repair. The average length of hospital stay was 2 days ± 3.6; six patients were discharged within 24 hours of the procedure. All patients were eligible for chemotherapy and radiation therapy immediately after the procedure.
  
  
  CONCLUSIONS
  MIAS is feasible, improves pain and mobility, and offers a minimally invasive alternative to open surgical reconstruction.
authors.affiliation: Division of Vascular and Interventional Radiology, Medical College of Wisconsin, 2109 East Olive Street, Milwaukee, WI 53211.
authors.forename: Michael P
authors.initials: MP
authors.lastname: Hartung
authors.affiliation: Division of Vascular and Interventional Radiology, Medical College of Wisconsin, 2109 East Olive Street, Milwaukee, WI 53211. Electronic address: stutton@mcw.edu.
authors.forename: Sean M
authors.initials: SM
authors.lastname: Tutton
authors.affiliation: Division of Vascular and Interventional Radiology, Medical College of Wisconsin, 2109 East Olive Street, Milwaukee, WI 53211; Department of Orthopedic Surgery, Medical College of Wisconsin, 2109 East Olive Street, Milwaukee, WI 53211.
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Hohenwalter
authors.affiliation: Department of Orthopedic Surgery, Medical College of Wisconsin, 2109 East Olive Street, Milwaukee, WI 53211.
authors.forename: David M
authors.initials: DM
authors.lastname: King
authors.affiliation: Department of Orthopedic Surgery, Medical College of Wisconsin, 2109 East Olive Street, Milwaukee, WI 53211.
authors.forename: John C
authors.initials: JC
authors.lastname: Neilson
mesh_terms: D055011:Ablation Techniques / Q000009:adverse effects; D000077:Acetabulum / Q000000981:diagnostic imaging / Q000293:injuries / Q000503:physiopathology / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001696:Biomechanical Phenomena; D001843:Bone Cements; D001859:Bone Neoplasms / Q000150:complications / Q000556:secondary / Q000601:surgery*; D001863:Bone Screws; D017024:Chemotherapy, Adjuvant; D005260:Female; D005593:Fracture Fixation, Internal / Q000009:adverse effects / Q000295:instrumentation*; D017102:Fracture Healing; D005598:Fractures, Spontaneous / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D019904:Polymethyl Methacrylate / Q000008:administration & dosage; D018714:Radiotherapy, Adjuvant; D020127:Recovery of Function; D012189:Retrospective Studies; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D001843:Bone Cements; D019904:Polymethyl Methacrylate