The Journal of Bone and Joint Surgery (American). 2009;91:1503-1516.
doi:10.2106/JBJS.H.00175
© 2009 The Journal of Bone and Joint Surgery, Inc.
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Current Concepts Review

Surgical Management of Metastatic Bone Disease

Jacob Bickels, MD1, Shlomo Dadia, MD1 and Zvi Lidar, MD1

1 National Unit of Orthopedic Oncology (J.B. and S.D.) and Spine Care Unit (Z.L.), Tel-Aviv Sourasky Medical Center, 6 Weizmann Street, Tel-Aviv 64239, Israel. E-mail address for J. Bickels: jbickels{at}012.net.il

Investigation performed at the Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel

Disclosure: The authors did not receive any outside funding or grants in support of their research for or preparation of this work. Neither they nor a member of their immediate families received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, division, center, clinical practice, or other charitable or nonprofit organization with which the authors, or a member of their immediate families, are affiliated or associated.

Metastatic bone disease is a major contributor to the deterioration of the quality of life of patients with cancer; it causes pain, impending and actual pathological fractures, and loss of function and may also be associated with considerable metabolic alterations.

Operative treatment may be required for an impending or existing fracture and intractable pain. The goals of surgery are to provide local tumor control and allow immediate weight-bearing and function. Radiation therapy is often indicated postoperatively.

Detailed preoperative evaluation is required to assess the local extent of bone destruction and soft-tissue involvement, involvement of other skeletal sites, and the overall medical and oncological status.


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