Quality of life in patients following percutaneous PMMA acetabuloplasty for acetabular metastasis due to carcinoma

Pain is the main symptom of acetabular osteolysis from metastatic carcinoma, and it is frequently associated with pathologic fractures. Radiotherapy alone usually is not effective for pain control, and it does not allow weight bearing. Surgical procedures requiring an aggressive approach and consequently high morbidity are rarely indicated in patients with multiple metastases. Polymethylmethacrylate (PMMA) has been widely used in oncologic and spinal surgery as a bone filler. We evaluated the functional results of percutaneous injection of PMMA in 20 patients (24 acetabula) with acetabular osteolysis from metastatic carcinoma. Patients were assessed before and after percutaneous acetabuloplasty, evaluating pain, mobility of the hip joint, general condition, use of analgesics, using the SF-36, QLQ-C30, Eastern Cooperative Oncology Group (ECOG) Performance Scale and Harris Hip Score. There was a marked clinical improvement in all patients during the first six post-operative months, with gradual worsening thereafter from deterioration of their general condition over the 12-month follow-up period. Percutaneous acetabuloplasty is reliable and effective in the short term, with a statistically significant reduction of pain and improvement in quality of daily life.