AORIF is a versatile minimally invasive, same-day-discharge procedure that is suited for skeletal metastases with pain and ambulatory dysfunction. AORIF is intended for reducing cancer burden by ablation, promoting tumor microenvironment for bone reconstitution, and restoring biomechanical competency of cancer-affected defective bones in the pelvis, sacrum, and periarticular bones of the femur, tibia, humerus, and other bones. Multiple AORIF can be done as a hip-joint or knee-joint preserving procedure. AORIF is an ideal first-line treatment for skeletal metastases in the periarticular bones, which facilitate the next-day anticancer drug therapies, before a formal open surgical procedures using intramedullary nailing or arthroplasty implants are considered. The minimally invasive nature of the AORIF minimized complications that may delay lifesaving or life-prolonging anticancer drug therapies.