» Wearable technologies (wearables), including smartphones, smartwatches, and sensors, such as accelerometers and inertial measurement units, enable continuous, real-time, and objective data collection on physical function, health behaviors, and patient perceptions. » Wearables can track mobility metrics such as step count, activity duration, and joint range of motion, providing valuable longitudinal insights into recovery trajectories. » In orthopaedic surgery, wearables support timely, personalized patient education and improve communication between patients and surgical teams, contributing to better functional outcomes and patient satisfaction. » Smart implants and virtual/augmented reality systems are emerging as innovative approaches to enhancing engagement and adherence during postoperative rehabilitation. » Key challenges to implementation include concerns about data privacy, accessibility, and integration into clinical workflows.

Background/Objectives: Metastatic bone disease (MBD) of the pelvis is commonly managed with open reconstruction despite substantial morbidity and high complication rates ranging from 16–32%. Percutaneous fixation techniques have emerged as a lower morbidity alternative; however, robust evaluations of outcomes remain limited. Therefore, the primary aim of this systematic review was to evaluate changes in pain and function following percutaneous fixation for pelvic MBD, and to determine the complication and reoperation rates of these procedures. Methods: A systematic review and meta-analysis was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. MEDLINE, Embase, Scopus, and Cochrane Library databases were searched from inception through 15 May 2025. Studies evaluating percutaneous fixation for pelvic MBD in adults were included. Pooled estimates of visual analog scale (VAS) pain scores, Eastern Cooperative Oncology Group (ECOG) performance status scores, complication rates, and reoperation rates were generated using meta-analysis techniques. Results: Twenty-five studies were included in the final analysis. VAS pain scores were reported in 15 studies, with an average decrease of 5.0 points (95% CI: 3.9–6.1) from pre- to postoperative. ECOG performance status scores were reported in 8 studies, with an average improvement of 1.1 points (95% CI: 0.7–1.5) from pre- to postoperative. Complications were reported in 24 studies, with a pooled complication rate of 8% (95% CI: 6–12%) and reoperation rate of 4% (95% CI: 2–7%). Conclusions: Percutaneous fixation for pelvic MBD provides meaningful improvements in pain and function with relatively low complication rates. However, substantial study heterogeneity exists in the patient population, surgical techniques, and implant selection, reflecting the novelty of this treatment strategy and the absence of standardized guidelines.