Cup‐Cage Solution for Massive Acetabular Defects: A Systematic Review and Meta‐Analysis

Abstract

Our systematic review compiled multiple studies and evaluated survivorship and clinical outcomes of cup‐cage construct usage in the management of massive acetabular bone defects. This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines. Various combinations of “acetabular”, “pelvis”, “cup cage” and their corresponding synonyms were used to search relevant articles in the Cochrane, EMBASE, and PubMed databases. Basic information of the functional scores, implant revision rate, and complication rate were selected as outcomes for analysis. Finally, a total of 11 articles published between 1999 and 2019 were selected, which include 232 patients with an average age of 68.5 years (range, 30–90). The mean follow‐up period was 48.85 months (range, 1–140). Our study shows that the cup‐cage construct has a good clinical outcome with a low revision rate and a low complication rate. Improved clinical outcomes of cup‐cage constructs were seen with a revision rate of 8% and an all‐cause complication rate of 20%. The most commonly reported complication was dislocation, followed by aseptic loosening, infection, and nerve injuries. In summary, it is a promising method for managing large acetabular bone defects in total hip revision.

Pelvic discontinuity: a challenge to overcome

“…The main reason for revision was dislocation (6.4% of cases), infection (6.4% of cases) and aseptic loosening (3.5% of cases). Similar results were presented in a more recent systematic review by Wang et al, 63 who reported the outcome of 232 patients who underwent revision THR, mainly presenting with AAOS type III and type IV defects. The mean follow-up period was 48.85 months (range, 1–140).…”

Standard Versus Custom-Made Acetabular Implants in Revision Total Hip Arthroplasty

“…A systematic review and meta-analysis, which included a study of the results of using cup-cage constructs in 232 cases of revision arthroplasty, showed the proportion of revisions of the acetabular component was 8% (12 cases). In 8 of these 12 cases, the reason for revision was aseptic loosening; the average follow-up was 48.8 months [28].…”

Acetabular Peri-Prosthetic Fractures—A Narrative Review

“…A polyethylene liner is then cemented in the cage in the correct position. Advantages of this technique are its favourable outcomes and high survival rates, ranging from 75–100% [ 37 , 42 , 48 , 49 , 50 , 51 , 52 ]. The main complications of this technique are dislocation (7–8%), infection (4–7%) and aseptic loosening (4–15%) [ 37 , 42 , 48 , 49 ].…”

“…Advantages of this technique are its favourable outcomes and high survival rates, ranging from 75–100% [ 37 , 42 , 48 , 49 , 50 , 51 , 52 ]. The main complications of this technique are dislocation (7–8%), infection (4–7%) and aseptic loosening (4–15%) [ 37 , 42 , 48 , 49 ]. Acetabular distraction was first described by Sporer et al in 2012 [ 53 ].…”