Acetabular revision with allograft bone: 103 revisions with 3 reconstruction alternatives, followed for 0.3–13 years

Acetabular Cage Survival and Analysis of Factors Related to Failure

“…The results of cage reconstruction have been highly variable, ranging from 69% to 100% [5,6,14,21,23,25,27,34,37,41]. Unfortunately, few of these studies used survivorship analysis that would make it possible to Fig.…”

“…Only one study other than ours looked at the influence of different factors on cage failure. Bohm and Banzhaf [6] identified three factors that correlated with failure: lack of radiographic incorporation of allograft, graft resorption, and use of particulate (morselized) as opposed to bulk (structural) allograft. However, the first two factors may only become radiographically evident when failure is imminent or has occurred.…”

“…Prior reports on the reconstructive cages have shown wide variability of results with cage survival ranging from 69% to 100% at varying times [5,6,14,21,23,25,27,34,37,38,41], complicating comparison with existing and future methods of reconstruction. This is partly attributable to nonactuarial methods and unclear definitions of end points (cage removal, any acetabular reoperation, or radiographic loosening) in estimating cage survivorship.…”

“…This is partly attributable to nonactuarial methods and unclear definitions of end points (cage removal, any acetabular reoperation, or radiographic loosening) in estimating cage survivorship. Furthermore, only one study attempted to look at factors that may be related to cage failure [6]. However, in this study, the authors primarily reported the results of allograft bone for acetabular revision and thus included reconstructions with cage and noncage devices.…”

Clinical evaluation and surgical options in acetabular reconstruction: A literature review

“…True survivorship of cages is unclear but has ranged from less than 70% to 100% according to Sembrano et al who report that the end-points of each study varied depending on time of cage removal, evidence of radiographic loosening, and reason for revision. [17][18][19][20][21][22][23][24][25][26][27] Regis et al reported an 87% (49/56) survival rate at a mean follow-up of 11.7 years in type IIIA (32%) and IIIB (68%) hips using cages and structural allografts using radiographic evidence of bone ingrowth and remodeling as the primary endpoint. 28 The major disadvantage of cages includes high complication rates previously reported by multiple authors.…”