Analysis of the Results of Use of Bone Graft and Reconstruction Cages in a Group of Patients with Severe Acetabular Bone Defects

Introduction. Rings and cages are indicated for use in revision total hip with severe bone loss. Material and Methods. A retrospective study was performed on 37 acetabular revision cases with an average age at revision of 67.8 years. According to Paprosky classification, 54% grade II and 46% grade III. We used two types of cages, Protrusio and Contour cage. We used 23 standard liners and 14 dual mobility cups. Results. The average follow-up was 5.4 years. The mean Merlé-d’Aubigné score improved from 5.48 to 10.5 points ( P < 0.05 ). There were 10 nerve palsies, 6 rings that lost fixation, 10 dislocations, and 4 infections. The need for reoperation for any reason rose to 32% (12/37). Success, defined as a stable reconstruction, was 73%. We found that, using a dual mobility cup cemented into the cage, the dislocation rate and revision rate came down ( P < 0.05 ). Conclusions. The treatment of severe acetabular defects using bone graft and reconstruction cages is a viable option. The use of a dual mobility cup cemented into the cage could avoid dislocations and the insertion of the ischial flap inside the ischial portion of the acetabulum for further ring stability and protection of the sciatic nerve.