{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T09:09:35Z","timestamp":1790845775636,"version":"4.1.0"},"reference-count":18,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Journal of Bone and Joint Surgery"],"published-print":{"date-parts":[[2020,4,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Metastatic lesions in the periacetabular region can cause pain and immobility. Symptomatic patients are often treated surgically with a total hip replacement using various modified Harrington methods. These open surgical procedures confer inherent risks. Prolonged recovery and potential complications may delay adjuvant radiation and systemic therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We describe a novel technique for acetabular reconstruction. Three large-bore cannulated screws are placed percutaneously under fluoroscopy in a tripod configuration to reinforce the mechanical axes of the acetabulum. Increased stability improves pain control and permits weight-bearing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Twenty consecutive patients with periacetabular metastases were treated using the tripod technique. Eighteen patients (90%) had Harrington class-III lesions, and 2 patients had Harrington class-II lesions. The mean surgical time was 2.3 hours. Sixteen patients (80%) were able to get out of bed on postoperative day 1. At 3 months postoperatively, there was significant improvement in pain as documented on their visual analog scale (p &lt; 0.01) and in functionality as measured by the Eastern Cooperative Oncology Group score (p &lt; 0.01). The mean follow-up time was 7 months (range, 0.6 to 20 months). At the most recent follow-up, only 3 among the 16 surviving patients were using opioids chronically for pain. Total hip arthroplasty was performed in 4 patients (20%) in a staged fashion using the previously placed screws as support for a cemented cup and obviating the need for a cage device. Of the 16 patients, 15 could walk either independently (6 patients) or using an ambulatory aid (9 patients). Eight patients with the primary tripod reconstruction survived &gt;6 months postoperatively. They were found to have either new bone formation filling the defects or healing of the pathological fractures. There has been no implant loosening or failure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>The tripod technique is a novel application to provide safe and effective pain relief in the context of periacetabular metastatic disease. It can be easily converted to support a cemented acetabular cup for a total hip replacement should disease progression occur. This technique provides an alternative to open surgery as currently practiced in these patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>\n                      Therapeutic\n                      <jats:underline>Level IV<\/jats:underline>\n                      . See Instructions for Authors for a complete description of levels of evidence.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.19.00936","type":"journal-article","created":{"date-parts":[[2020,2,21]],"date-time":"2020-02-21T00:12:37Z","timestamp":1582243957000},"page":"592-599","source":"Crossref","is-referenced-by-count":60,"title":["A Novel Tripod Percutaneous Reconstruction Technique in Periacetabular Lesions Caused by Metastatic Cancer"],"prefix":"10.2106","volume":"102","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6291-8747","authenticated-orcid":false,"given":"Rui","family":"Yang","sequence":"first","affiliation":[{"name":"Departments of Orthopaedic Surgery (R.Y., A.G., D.M., J.W., V.C., B.H., and D.G.) and Radiation Oncology (J.F.), Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2168-2907","authenticated-orcid":false,"given":"Abraham","family":"Goch","sequence":"additional","affiliation":[{"name":"Departments of Orthopaedic Surgery (R.Y., A.G., D.M., J.W., V.C., B.H., and D.G.) and Radiation Oncology (J.F.), Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8051-2510","authenticated-orcid":false,"given":"Dennis","family":"Murphy","sequence":"additional","affiliation":[{"name":"Departments of Orthopaedic Surgery (R.Y., A.G., D.M., J.W., V.C., B.H., and D.G.) and Radiation Oncology (J.F.), Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9380-001X","authenticated-orcid":false,"given":"Jichuan","family":"Wang","sequence":"additional","affiliation":[{"name":"Departments of Orthopaedic Surgery (R.Y., A.G., D.M., J.W., V.C., B.H., and D.G.) and Radiation Oncology (J.F.), Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York"},{"name":"Department of Orthopaedic Oncology, Peking University, People\u2019s Hospital, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3062-4178","authenticated-orcid":false,"given":"Vanessa","family":"Charubhumi","sequence":"additional","affiliation":[{"name":"Departments of Orthopaedic Surgery (R.Y., A.G., D.M., J.W., V.C., B.H., and D.G.) and Radiation Oncology (J.F.), Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8526-8588","authenticated-orcid":false,"given":"Jana","family":"Fox","sequence":"additional","affiliation":[{"name":"Departments of Orthopaedic Surgery (R.Y., A.G., D.M., J.W., V.C., B.H., and D.G.) and Radiation Oncology (J.F.), Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2733-7132","authenticated-orcid":false,"given":"Milan","family":"Sen","sequence":"additional","affiliation":[{"name":"Division of Orthopaedic Surgery, Jacobi Medical Center, Bronx, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2950-3221","authenticated-orcid":false,"given":"Bang","family":"Hoang","sequence":"additional","affiliation":[{"name":"Departments of Orthopaedic Surgery (R.Y., A.G., D.M., J.W., V.C., B.H., and D.G.) and Radiation Oncology (J.F.), Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4549-7124","authenticated-orcid":false,"given":"David","family":"Geller","sequence":"additional","affiliation":[{"name":"Departments of Orthopaedic Surgery (R.Y., A.G., D.M., J.W., V.C., B.H., and D.G.) and Radiation Oncology (J.F.), Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2020,2,19]]},"reference":[{"issue":"11","key":"bib1-20230810","doi-asserted-by":"crossref","first-page":"685","DOI":"10.5435\/JAAOS-21-11-685","article-title":"Management of metastatic bone disease of the acetabulum","volume":"21","author":"Issack","year":"2013","journal-title":"J Am Acid Orthop 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