Outcome and EBRA migration analysis of a reconstruction cage in acetabular revision arthroplasty: a clinical and radiological study

Abstract

Purpose: Restoration cages and bone allografts have been proposed to manage severe acetabular bone defects. We aimed to investigate the migration behaviour of a restoration cup and impacted allograft bone in severe acetabular defects with Einzel-Bild-Röntgen-Analyse (EBRA). Methods: Applying a retrospective study design, 64 cases treated between 2009 and 2016 were reviewed. We determined the preoperative Charlson Comorbidity Index (CCI), pre- to postoperative WOMAC score, blood loss and functional outcome. From preoperative x rays, the acetabular deficiencies were classified according to Paprosky. Cup migration analyses were performed with EBRA. Results: Mean age at surgery was 73 (range: 38–93) years. According to the classification by Paprosky et al., 50% (n = 32) of our patients showed a type III B and 28.1% (n = 18) a type III A defect. Radiological follow-up for migration analysis was 35 (range: 4–95) months. Migration analysis showed a mean cup migration of 0.7 mm (range: 5.7–9.6) medial and 1.8 mm (range: 1.7–12.6) cranial. Conclusion: In conclusion, acetabular restoration cages in combination with bone impaction grafting showed a low revision rate at a mean follow-up of 35 months. Mean cup migration revealed low rates after 2 years and suggested a stable postoperative implant position.