Background: To evaluate the feasibility, safety and therapeutic effect of combined radiofrequency (RF) ablation and cementoplasty for pain reduction and quality of life improvement in patients with painful acetabular metastases.

Methods: 19 patients with acetabular metastases were treated with percutaneous RF ablation followed by cementoplasty for management of pain and joint instability over a period of 13 months.
Objective assessment of severity of pain done using Visual analogue scale (VAS). European Organisation for Research and Treatment of Cancer (EORTC) QLQ C-30 Version 3.0 scale was followed for assessment of quality of life.
RF ablation was done under CT guidance followed by cementoplasty in the same session under deep sedation (n=11) or general anaesthesia (n=8).
Following RF ablation, severity of pain and improvement in quality of life were again objectively assessed using VAS and EORTC QLQ C- 30 Version 3.0 scale after 24 hours respectively.
Only one session of RF ablation was done in all patients.
Patients were followed up for pain severity and quality of life assessment at 3 weeks, 3months, 6 months, 9 months and 12 months duration. Mean follow up was for 9.4 months.

Results: 19 patients with painful acetabular metastases were treated with combination of RF ablation and cementoplasty.
The primary sites were renal in 09(47.4 %), thyroid in 08 42.1 %) and breast in 02 (10.5%).
The procedure was technically successful in all patients. Homogenous distribution of cement was achieved in all patients.
No significant intravasation , pulmonary embolism or intra articular leak of cement was noted.
Patients reported significant reduction in severity of pain (Mean pain score 8 before treatment and 3.2 after treatment at 9 months follow up).
Reliability Test - Cronbach’s Alpha (0-1) was > 0.70
P Value < 0.001 for Paired Sample Test.
Mean EORTC QLQ - C30 score improved from 35.33 to 70.63 after 9 months of follow up.

Conclusions: Painful acetabular metastases can be effectively treated by targeted RF ablation with cementoplasty.
The combined treatment causes significant reduction in pain and stability of the hip joint thus contributing to improved quality of life.