What question did this study set out to answer?

This research aims to evaluate the effectiveness of a novel screw-and-cement pile technique for treating Harrington II/III periacetabular lesions.

February 27, 2026Open Access

A novel screw-and-cement pile technique for Harrington II/III periacetabular lesions: technical note and short-term outcomes

Key Points

This research aims to evaluate the effectiveness of a novel screw-and-cement pile technique for treating Harrington II/III periacetabular lesions.
Retrospective, two-center case series on six patients with Harrington II/III lesions.
Surgical procedures included curettage, screw placement, PMMA embedding, and polyethylene cup implantation.
Outcomes assessed included pain scores, limb function, and complications.
Mean age of patients was 65.8 years, with a follow-up of 13.3 months.
VAS pain scores improved significantly from 7.3 preoperatively to 1.0 at 1 month.
Harris Hip Scores increased from 30.7 preoperatively to 86.2 at final follow-up, indicating functional improvement.
No postoperative complications were reported, and all patients remained alive with no local progression.

Abstract

Background Periacetabular metastases, particularly Harrington type II/III lesions, frequently lead to acetabular insufficiency, femoral head migration, and severe pain. We developed a simplified screw-and-cement pile technique using readily available screws, left partially proud, to interlock with polymethylmethacrylate (PMMA), supporting a standard polyethylene cup through a single conventional approach to reconstruct the damaged acetabular structure. Methods We performed a retrospective, two-center case series involving six consecutive patients, three with Harrington type II lesions and three with Harrington type III lesions. Surgical procedures included curettage, screw placement toward the acetabular dome, with additional screws to the pubic and ischial rami as needed, PMMA embedding, and implantation of a standard polyethylene cup via a posterolateral approach. Outcomes assessed included surgical invasiveness, pain (VAS), limb function, complications, and oncologic outcomes. Results The mean age of the patients was 65.8 ± 6.1 years, with a mean follow-up of 13.3 ± 7.9 months. The mean operative time was 148.3 ± 27.9 minutes, and average blood loss was 650.0 ± 367.4 mL. VAS scores improved from 7.3 ± 0.5 preoperatively to 1.0 ± 0.6 at 1 month (p 0.001). The Harris Hip Score (HHS) increased from 30.7 ± 5.6 preoperatively to 81.7 ± 1.9 at 1 month and 86.2 ± 2.7 at final follow-up (both p 0.001). The MSTS-93 score averaged 20.7 ± 1.0 at 1 month and 22.3 ± 0.8 at final follow-up. No postoperative complications occurred. All patients were alive at the last follow-up, with no evidence of local progression, and all received disease-specific systemic therapy. Conclusion In short-term follow-up, the screw-and-cement pile technique for Harrington II/III acetabular defects provided rapid pain relief and functional improvement without early complications. Featuring a simple approach and low-cost implants, it is a viable palliative option for achieving immediate stability and symptom control. Longer-term studies are warranted to evaluate its durability.

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