title: The role of cages in the management of severe acetabular bone defects at revision arthroplasty.
abstract: An uncemented hemispherical acetabular component is the mainstay of acetabular revision and gives excellent long-term results. Occasionally, the degree of acetabular bone loss means that a hemispherical component will be unstable when sited in the correct anatomical location or there is minimal bleeding host bone left for biological fixation. On these occasions an alternative method of reconstruction has to be used. A major column structural allograft has been shown to restore the deficient bone stock to some degree, but it needs to be off-loaded with a reconstruction cage to prevent collapse of the graft. The use of porous metal augments is a promising method of overcoming some of the problems associated with structural allograft. If the defect is large, the augment needs to be protected by a cage to allow ingrowth to occur. Cup-cage reconstruction is an effective method of treating chronic pelvic discontinuity and large contained or uncontained bone defects. This paper presents the indications, surgical techniques and outcomes of various methods which use acetabular reconstruction cages for revision total hip arthroplasty.
authors.affiliation: Mount Sinai Hospital, University of Toronto, 600 University Avenue, Toronto, Ontario M5G 1X5, Canada.
authors.forename: T J
authors.initials: TJ
authors.lastname: Mäkinen
authors.affiliation: Mount Sinai Hospital, University of Toronto, 600 University Avenue, Toronto, Ontario M5G 1X5, Canada.
authors.forename: S G
authors.initials: SG
authors.lastname: Fichman
authors.affiliation: Mount Sinai Hospital, University of Toronto, 600 University Avenue, Toronto, Ontario M5G 1X5, Canada.
authors.forename: E
authors.initials: E
authors.lastname: Watts
authors.affiliation: Mount Sinai Hospital, University of Toronto, 600 University Avenue, Toronto, Ontario M5G 1X5, Canada.
authors.forename: P R T
authors.initials: PR
authors.lastname: Kuzyk
authors.affiliation: Mount Sinai Hospital, University of Toronto, 600 University Avenue, Toronto, Ontario M5G 1X5, Canada.
authors.forename: O A
authors.initials: OA
authors.lastname: Safir
authors.affiliation: Mount Sinai Hospital, University of Toronto, 600 University Avenue, Toronto, Ontario M5G 1X5, Canada.
authors.forename: A E
authors.initials: AE
authors.lastname: Gross
mesh_terms: D000077:Acetabulum / Q000601:surgery*; D019644:Arthroplasty, Replacement, Hip / Q000295:instrumentation* / Q000379:methods*; D001847:Bone Diseases / Q000601:surgery*; D016025:Bone Transplantation; D006801:Humans; D012086:Reoperation; D012720:Severity of Illness Index
keywords: Revision total hip arthroplasty; Acetabular bone defect; Reconstructive cage; Structural allograft; Metal augment; Cup-cage reconstruction