This post was written based on an interview with Dr. Chris Johnson, DO, orthopedic oncology surgeon and president of Orthopedics NorthEast.
When it comes to complex orthopedic oncology, we blend innovation, experience and multidisciplinary care. This approach supports our ability to pioneer new techniques that are reshaping patient recovery and outcomes.
Rethinking a clinical challenge
Metastatic acetabular is when cancer spreads to the socket of the hip joint (acetabulum), from another part of the body. Traditionally, surgeons have treated metastatic acetabular defects using extensive procedures like the Harrington reconstruction, which requires multiple incisions and can leave patients with long recoveries. It’s a big surgery, taking down abductors and opening multiple areas of the pelvis. It’s invasive and takes time to heal.
That began to change with the introduction of the tripod technique, first popularized by Dr. David Geller’s team in the Bronx, which uses percutaneous screws to stabilize the acetabulum through small incisions. Our team adopted and refined this technique, combining it with the anterior approach to minimize soft tissue damage and improve recovery.
Now, we can often treat metastatic disease without cutting any muscle. Many of these patients are walking at six weeks. Some even the day of surgery. That’s a huge improvement over what we used to see.
Setting goals for patients
Patients with metastatic acetabular disease typically present with groin or inguinal pain, similar to arthritis symptoms, but the underlying cause is tumor-related bone destruction. Each case is unique, depending on the primary cancer type, the extent of bone loss, and the patient’s overall condition.
These are big surgeries and should always involve a multidisciplinary team, including oncology, radiation and orthopedics. We talk with patients and families about risks and benefits. But the anterior approach has allowed us to be more proactive surgically because recovery is faster and less invasive.
The ultimate goal differs from traditional arthroplasty. Our priority isn’t longevity of the implant, it’s immediate weightbearing and function. These patients may be receiving chemotherapy or have limited life expectancy. Getting them walking right away improves their quality of life and helps them tolerate other treatments.
Recovery and rehabilitation
Perhaps the most striking change since adopting the anterior approach is how quickly patients mobilize. If there’s no abductor involvement, I let them walk right away, just like a routine anterior hip replacement. We don’t usually need formal therapy unless they’re very deconditioned.
Our team works closely with oncology-specific physical therapists, and postoperative follow-up focuses heavily on wound monitoring, particularly for immunocompromised patients or those receiving targeted therapies. If the wound looks good at two weeks, I clear them for chemo or radiation.
Looking ahead
We are working to develop a new research institute within our practice to study long-term outcomes and innovations in orthopedic oncology. There’s still a lot we don’t know, especially around implant longevity, fixation choices and survivorship in this unique population.
But for now, the focus remains on patient-centered care and improving quality of life. At the end of the day, it’s about helping people walk again — safely, quickly and with dignity. The anterior approach has made that possible for patients who, not long ago, didn’t have many options.
Want to learn more?
To schedule orthopedic care in Allen County, call Ortho NorthEast at 260-484-8551 or request an appointment here, or visit this page to find orthopedic care outside of Allen County.
Curious about your genetic risk for certain cancers? Learn how your DNA affects your health with DNA Insights, a community health research program by Parkview Health. Learn more at parkview.com/DNAInsights.
