ACETABULOPLASTY

What is acetabuloplasty:

• Percutaneous acetabuloplasty is a minimally invasive procedure for the management of Primary or metastatic lytic lesions of the acetabulum causing hip pain. 
• Osteolytic metastases around the acetabulum are common in patients having tumor.

Why it is necessary:

• It may cause intense and drug-resistant pain of the hip because of structural weakening of the pelvis. 
• It may sometimes lead to pathological fractures, forcing the patients to bed rest, and considerable increase of co-morbidity.
• So it is necessary in patients having:
  • Weight bearing acetabular osteolysis,
  • Hip pain resistant to drugs
  • Patients who cannot tolerate major surgery and refractory to radiotherapy.

How it performed:

• A 11 gauge bone biopsy needle, under fluoroscopic guidance, is passed into the acetabular bone followed by injection of acrylic bone cement (commonly polymethylmethacrylate; PMMA) into lytic acetabular cavity through biopsy needle.

What are benefits:

•  Immediately restore the mechanical properties of the affected acetabular segment.
• It also reduces or eliminates pain. So it improves the quality of life of patients with osteolytic bone tumours.

Preparation for procedure:

• Few basic blood investigations like CBC, PT/INR, viral markers.
• Bring all the records including imaging record.
• Signing consent form.

What are risks:

• Very less; Cement leak, joint damage or infection (<1 case in 1000).