The Treatment of Pelvic Discontinuity with Acetabular Cages

We sought to determine if acetabular cages prevented rerevision and loosening in acetabular reconstructions in the setting of pelvic discontinuity. We followed 15 patients with 16 acetabular cage reconstructions for an average 5 years (range, 2-8 years). Acetabular classifications included two Type 2C, six Type IIIA, and eight Type IIIB. We assessed Merle d’Aubigné scores, rerevisions, radiographic loosening, and complications. We treated seven patients with structural allograft and six patients with cancellous allograft. Five hips (31%) were revised or resected because of aseptic loosening (4 hips) and sepsis (1 hip) at an average 46 months. Three additional hips were loose. Merle d’Aubigné scores for pain and walking increased from 3.7 points preoperatively to 6.8 points at the final followup. Complications included one infection, four nerve palsies, and one dislocation. Acetabular cages in the setting of pelvic discontinuity were associated with a high failure rate at intermediate-term followup.

Level of Evidence: Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.