Survival of the GAP II cage in the management of metastatic disease of the acetabulum. (1st April 2022)

• Record Type: Journal Article
• Authors: Kennedy, John W.; Farhan-Alanie, Omer M.; Young, David; Kelly, Michael P.; Young, Peter S.
• Is Part Of: Bone & joint journal. Volume 104B:Number 4(2022)
• Page Start: 504
• Page End: 509
• Publication Date: 2022-04-01
• Subjects: Metastatic disease -- Acetabulum -- Total hip arthroplasty -- Metastatic disease of the acetabulum -- bony metastases -- Acetabular component -- acetabulum -- Postoperative radiographs -- femoral component -- acetabular cages -- debridement -- metastatic disease -- postoperative complications; Bones -- Surgery -- Periodicals; Joints -- Surgery -- Periodicals; Orthopedic surgery -- Periodicals; 617.47005
• DOI: 10.1302/0301-620X.104B4.BJJ-2021-1227.R1
• Languages: English
• ISSNs: 2049-4394

Abstract

Abstract : Aims: The aim of this study was to assess the clinical and radiological outcomes of an antiprotrusio acetabular cage (APC) when used in the surgical treatment of periacetabular bone metastases. Methods: This retrospective cohort study using a prospectively collected database involved 56 patients who underwent acetabular reconstruction for periacetabular bone metastases or haematological malignancy using a single APC between January 2009 and 2020. The mean follow-up was 20 months (1 to 143). The primary outcome measure was implant survival. Postoperative radiographs were analyzed for loosening and failure. Patient and implant survival were assessed using a competing risk analysis. Secondary parameters included primary malignancy, oncological treatment, surgical factors, length of stay in hospital, and postoperative complications. Results: A total of 33 patients (59%) died during the study period at a mean of 15 months postoperatively (1 to 63). No patient had radiological evidence of loosening or failure. Acetabular component survival was 100%. Three patients (5.4%) had further surgery; one (1.8%) underwent revision of the femoral component for dislocation, one required debridement with implant retention for periprosthetic joint infection, and one required closed reduction for dislocation. Using death as a competing risk, at 100 months, the probability of revision was 0.036 and the risk of death was 0.84. Conclusion: With appropriate patient selection, the antiprotrusio cage offers good implant survival, with a reasonable perioperative complication rate in this high-risk group of patients when managing metastatic disease or haematological malignancy around the acetabulum. Cite this article: Bone Joint J 2022;104-B(4):504–509.