Percutaneous fixation for pelvic metastatic bone disease improves pain and function with low complication rates: a systematic review and meta-analysis
Location
LSU Health NO Center for Advanced Learning and Simulation (CALS)
Document Type
Event
Start Date
20-6-2026 10:20 AM
End Date
20-6-2026 11:20 AM
Publication Date
June 2026
Description
Introduction: Metastatic bone disease (MBD) of the pelvis is commonly managed with open reconstruction despite substantial morbidity and high complication rates ranging from 16-32%. Percutaneous fixation techniques have emerged as lower morbidity alternatives; however robust evaluations of outcomes remain limited. This systematic review and meta-analysis evaluated the clinical outcomes and complications following percutaneous fixation for pelvic MBD.
Methods: A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies were included if they were a) primary research studies, (b) human-based studies, (c) in an adult MBD population, (d) included tumors located in the pelvis or acetabulum, and (e) evaluated percutaneous fixation techniques. Visual analog scale (VAS) pain scores, Eastern Cooperative Oncology Group (ECOG) performance status, complications, and re-operation rates were analyzed using meta-analysis techniques.
Results: Twenty-five studies were included in the final analysis. VAS pain scores were reported in 60% of studies, with an average decrease of 5.0 points (95% CI: 3.9-6.1) from pre- to postoperative. ECOG performance status scores were reported in 32% of studies, with an average improvement of 1.1 points (95% CI: 0.7-1.5) from pre- to postoperative. Complications were reported in 96% of studies, with a pooled complication rate of 8% (95% CI: 6-12%) and reoperation rate of 4% (95% CI: 2-7%).
Discussion: Percutaneous fixation provides meaningful improvements in pain and function with lower complications rates than open reconstructions. These findings support percutaneous fixation as a lower-morbidity strategy for appropriately selected patients with mechanically unstable pelvic MBD. Significance/Clinical relevance: Percutaneous fixation may reduce complication rates while maintaining meaningful improvements in pain and function, supporting its use as a lower-morbidity alternative to open reconstruction in pelvic metastatic bone disease.
Recommended Citation
Carter, Zachary, "Percutaneous fixation for pelvic metastatic bone disease improves pain and function with low complication rates: a systematic review and meta-analysis" (2026). Dept. of Orthopaedics: Robert D. D’Ambrosia Lectureship & Research Day. 4.
https://digitalscholar.lsuhsc.edu/ortho_rd/2026/student/4
Percutaneous fixation for pelvic metastatic bone disease improves pain and function with low complication rates: a systematic review and meta-analysis
LSU Health NO Center for Advanced Learning and Simulation (CALS)
Introduction: Metastatic bone disease (MBD) of the pelvis is commonly managed with open reconstruction despite substantial morbidity and high complication rates ranging from 16-32%. Percutaneous fixation techniques have emerged as lower morbidity alternatives; however robust evaluations of outcomes remain limited. This systematic review and meta-analysis evaluated the clinical outcomes and complications following percutaneous fixation for pelvic MBD.
Methods: A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies were included if they were a) primary research studies, (b) human-based studies, (c) in an adult MBD population, (d) included tumors located in the pelvis or acetabulum, and (e) evaluated percutaneous fixation techniques. Visual analog scale (VAS) pain scores, Eastern Cooperative Oncology Group (ECOG) performance status, complications, and re-operation rates were analyzed using meta-analysis techniques.
Results: Twenty-five studies were included in the final analysis. VAS pain scores were reported in 60% of studies, with an average decrease of 5.0 points (95% CI: 3.9-6.1) from pre- to postoperative. ECOG performance status scores were reported in 32% of studies, with an average improvement of 1.1 points (95% CI: 0.7-1.5) from pre- to postoperative. Complications were reported in 96% of studies, with a pooled complication rate of 8% (95% CI: 6-12%) and reoperation rate of 4% (95% CI: 2-7%).
Discussion: Percutaneous fixation provides meaningful improvements in pain and function with lower complications rates than open reconstructions. These findings support percutaneous fixation as a lower-morbidity strategy for appropriately selected patients with mechanically unstable pelvic MBD. Significance/Clinical relevance: Percutaneous fixation may reduce complication rates while maintaining meaningful improvements in pain and function, supporting its use as a lower-morbidity alternative to open reconstruction in pelvic metastatic bone disease.