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

Chao-Xin Wang1, Zi-da Huang1, Bai-Jian Wu1

  • 1Department of Orthopaedic Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China.

Orthopaedic Surgery
|June 5, 2020
PubMed
Summary

The cup-cage construct demonstrates good clinical outcomes for managing massive acetabular bone defects. This method shows a low revision rate (8%) and complication rate (20%), making it promising for total hip revision surgery.

Keywords:
Acetabular defectBone defectsCup-cageTotal hip revision

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Area of Science:

  • Orthopedic surgery
  • Biomedical engineering
  • Systematic review methodology

Background:

  • Massive acetabular bone defects pose significant challenges in total hip revision surgery.
  • Existing management strategies may have limitations in addressing severe bone loss.
  • The efficacy of the cup-cage construct requires comprehensive evaluation.

Purpose of the Study:

  • To systematically review and evaluate the survivorship and clinical outcomes of cup-cage constructs in managing massive acetabular bone defects.
  • To analyze functional scores, implant revision rates, and complication rates associated with this surgical technique.

Main Methods:

  • Systematic review adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
  • Searched Cochrane, EMBASE, and PubMed databases using keywords related to acetabular defects and cup-cage implants.
  • Included 11 studies published between 1999 and 2019, involving 232 patients (average age 68.5 years) with a mean follow-up of 48.85 months.

Main Results:

  • The cup-cage construct achieved a favorable clinical outcome.
  • The revision rate was low at 8%, and the all-cause complication rate was 20%.
  • Common complications included dislocation, aseptic loosening, infection, and nerve injuries.

Conclusions:

  • The cup-cage construct is a promising surgical option for managing massive acetabular bone defects.
  • It offers good survivorship and acceptable complication rates in total hip revision procedures.
  • Further research may focus on optimizing surgical techniques and managing specific complications.