A graphic guide to the percutaneous tripod acetabular reconstruction for metastatic cancer

Rui Yang, Jichuan Wang, Megan M. Mizera, Sandip P. Tarpada, Mani Seetharaman, Milan K. Sen, Bang Hoang, David S. Geller

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Symptomatic peri-acetabular metastatic lesions are often treated with open surgery such as modified Harrington procedures. In an effort to avoid surgical complications inherently associated with open surgical approaches, we developed and recently reported a novel Tripod percutaneous screw technique. The tripod technique is minimally invasive and was found to yield excellent outcomes regarding both pain control and functionality. The procedure is performed in a standard operative theater using fluoroscopic guided percutaneous screws. Despite the simplicity of intraoperative set-up and instrumentation, it is technically demanding. Obtaining the correct fluoroscopic views and troubleshooting intraoperative hurdles can be challenging for even an experienced orthopedic surgeon. The technique and bony conduits were previously described in the trauma literature, however, there are key points of difference in the setting of metastatic disease. Here we provide a compilation of a stepwise graphic guide for the tripod model in the setting of metastatic peri-acetabular lesions, as well as the tips and tricks based on our own experience. These encompass preoperative preparation, operating room settings, intraoperative fluoroscopic guidance, postoperative care, and subsequent conversion to a cemented total hip arthroplasty, if needed.

Original languageEnglish (US)
Pages (from-to)1316-1327
Number of pages12
JournalJournal of Surgical Oncology
Volume123
Issue number5
DOIs
StatePublished - Apr 1 2021

Keywords

  • percutaneous
  • peri-acetabular metastasis
  • reconstruction

ASJC Scopus subject areas

  • Surgery
  • Oncology

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