Surgical Management Update in Metastatic Disease of the Pelvis

Juan Pretell-Mazzini, Waleed Al-Hardan, Erika Garbrecht, Kyle Huntley

Research output: Contribution to journalArticlepeer-review

Abstract

Metastatic lesions of the pelvis present a surgical challenge as operative resection may result in impaired functionality or worsened disability. Accordingly, radiation and systemic medical therapy remain the mainstay options for local tumor control and pain relief. Surgical intervention is largely reserved for intractable pain, pending pathologic fracture, or severe disability. The pelvic anatomy is composed of the acetabulum, ileum, and pubis; each with varying biomechanical and surgical considerations. The acetabulum serves as the main load transmitter throughout the gait cycle, and resection with reconstruction may be necessary to preserve functionality. Current open operative techniques include total hip arthroplasty, saddle implants, or custom-made implants, while minimally invasive percutaneous surgical interventions have shown early promise. The Harrington classification system is a common method for guiding surgical management in periacetabular metastatic lesions, although recent modifications continue to be explored. In contrast to the acetabulum, the ileum and the pubis serve a limited weight-bearing function. Resections often do not require reconstruction and ambulation may be preserved.

Original languageEnglish (US)
Article number100897
JournalOperative Techniques in Orthopaedics
DOIs
StateAccepted/In press - 2021

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

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