Perioperative considerations in patients with metastatic bone disease.

Preoperative assessment of patients with metastatic bone disease includes a history and physical examination, laboratory evaluation, and standard radiographs. Perioperative diagnostics include technetium bone scan, CT scans, MR imaging, positron emission tomography, and biopsy. The role of preoperative tumor embolization and vena cava filter placement is discussed in this article. Guidelines for pain control are provided. Surgical planning and instrument considerations for long bone lesions, periarticular lesions, and pelvis and acetabular lesions are addressed. The importance of rehabilitation for patients with metastatic bone disease is emphasized.