This AAOS Instructional Course Lecture synthesizes the evaluation and management of metastatic bone disease — covering how to work up an unknown bone lesion, which fixation strategies to use based on life expectancy and tumor biology, and when minimally invasive or surgical options are appropriate for extremity and spinal metastases.
When you encounter a bone lesion in a patient over 40, complete the staging workup and obtain a tissue diagnosis before any surgical intervention — the 'rodded sarcoma' is a career-defining mistake that is entirely preventable.
When planning fixation for a pathologic fracture, match your construct to the patient's life expectancy and the tumor's healing potential: use PMMA for immediate stability, avoid bone graft and porous ingrowth implants, and fix the entire bone when possible to protect against future hematogenous deposits.
This AAOS Instructional Course Lecture synthesizes the evaluation and management of metastatic bone disease — covering how to work up an unknown bone lesion, which fixation strategies to use based on life expectancy and tumor biology, and when minimally invasive or surgical options are appropriate for extremity and spinal metastases.
When you encounter a bone lesion in a patient over 40, complete the staging workup and obtain a tissue diagnosis before any surgical intervention — the 'rodded sarcoma' is a career-defining mistake that is entirely preventable.
When planning fixation for a pathologic fracture, match your construct to the patient's life expectancy and the tumor's healing potential: use PMMA for immediate stability, avoid bone graft and porous ingrowth implants, and fix the entire bone when possible to protect against future hematogenous deposits.