1. Augmented osteoplasty of RCC metastasis in the femoral neck
Kelekis, DK Filippiadis
2nd Radiology Dpt,
University General Hospital “ATTIKON”, Athens/GR

2. CASE REPORT 59 y-o female patient
medical record of RCC (operated in 2010)
low back pain and cruralgia during the last 4 months

3. CASE REPORT * * * * B A
A: Computed Tomography scan illustrates a lytic lesion with soft tissue mass in the femoral neck (red asteriscs); notice the presence of PMMA in the right pubic bone (posterior) from previous osteoplasty (white arrow)
B: PET/CT scan illustrates positive uptake of the a lytic lesion with soft tissue mass in the femoral neck (arrow)

4. Cardiovasc Intervent Radiol. 2016 Jan;39(1):90-6.
TECHNIQUE A B C
Cardiovasc Intervent Radiol Jan;39(1):90-6.
Percutaneous Augmented Peripheral Osteoplasty in Long Bones of Oncologic Patients for Pain Reduction and Prevention of Impeding Pathologic Fracture:
The Rebar Concept.
Kelekis A, Filippiadis D, Anselmetti G, Brountzos E, Mavrogenis A, Papagelopoulos P, Kelekis N, Martin JB
A: Bone access needle was inserted along the femoral neck
B: MWA was performed (HS AMICA system )
C: A second bone access needle was inserted with cranio-caudal direction

5. TECHNIQUE D F E
D, E: Metallic micro-needles (22G) were co-axially introduced through both the access needles in order to create a mesh (rebar concept)
F: PMMA was injected covering the whole extent of the lesion and the metallic mesh and bridging the construct to normal bone

6. Q1: Biomechanical properties of PMMA render the material ideal for
Compression forces
Shear forces
Torsion forces
Bending forces
Tensile forces

7. Q1: Biomechanical properties of PMMA render the material ideal for
Compression forces (RIGHT ANSWER)
Shear forces
Torsion forces
Bending forces
Tensile forces

8. Q2: The most frequent delayed complication of cementoplasty in long bones using only PMMA
Leakage of the cement
Migration of the cement
Fracture
Infection
Hemorrhage

9. Q2: The most frequent delayed complication of cementoplasty in long bones using only PMMA
Leakage of the cement
Migration of the cement
Fracture (RIGHT ANSWER)
Infection
Hemorrhage