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Reconstruction for pelvic discontinuity and massive acetabular defects.
A Fraile Suari1, Fernando Marqués López1, M Cuenca Llavall1
1Servicio de Cirugía Ortopédica y Traumatología, Hospital del Mar i l'Esperança, Barcelona, España.
Revista Espanola De Cirugia Ortopedica Y Traumatologia (English Ed.)
|September 24, 2019
Summary
The Cup-Cage construct offers a valid solution for complex acetabular reconstruction in patients with massive defects and pelvic discontinuity. This study shows good short- and midterm outcomes with no implant failures observed.
Area of Science:
- Orthopaedic Surgery
- Reconstructive Surgery
- Biomaterials Engineering
Background:
- Massive acetabular defects and pelvic discontinuity present significant surgical challenges.
- Acetabular revision requires robust reconstructive techniques for optimal patient outcomes.
Purpose of the Study:
- To evaluate the short- and midterm clinical and radiological outcomes of acetabular revision using the Cup-Cage construct.
- To assess the efficacy of this technique in complex cases involving massive acetabular defects and pelvic discontinuity.
Main Methods:
- Retrospective review of 22 consecutive patients undergoing acetabular revision with a trabecular metal acetabular component and Cup-Cage system.
- Patients had massive acetabular defects (Paprosky IIIa/IIIB), pelvic discontinuity, or related complications.
- Clinical and radiological follow-up was conducted to monitor for mechanical failures and implant loosening.
Main Results:
- No radiographic failures (migration, osteolysis, implant/screw rupture) were observed at an average follow-up of 45.06 months.
- Complications occurred in 13.63% of patients (recurrent dislocation, infection, recurrent subluxation).
- Significant improvements were noted in Merle d'Aubigné-Postel scores (6.91 to 14.36), range of motion (2.91 to 4.36), and Harris Hip Score (30 to 72).
Conclusions:
- The Cup-Cage system serves as a viable alternative for acetabular reconstruction in cases of massive defects and pelvic discontinuity.
- The technique demonstrates favorable short- and midterm results, supporting its use in complex acetabular reconstructions.
