Acetabular reconstruction using a cage in complex primary total hip replacement in a developing country: An assessment of early functional outcome

Abstract

Background: Acetabular reconstruction following bone loss is a major challenge facing the arthroplasty surgeon. Traditionally, the armamentarium for the treatment of large bone defects (Paprosky Type 2C or 3) included antiprotrusio cages (APC). The aim of this study is to determine the pattern of presentation and assess the early functional outcome of patients who had undergone acetabular reconstruction using APC in complex primary total hip replacement (THR).

Patients and Method: Between November 2008 and November 2015, 38 THR were carried out in 35 patients who required acetabular reconstruction, at Davidson and Judith Consultants Clinics Enugu, Nigeria.

Results: There were 25 males and 10 females, with a ratio of 2.5:1. The average age of the patients was 61.33 ± 6.92 with a range of 56 to 72. The mean pre‑op Harris score was 49.02 ± 2.3.The mean post‑op Harris hip score (HSS) was 88.75 ± 10 (P < 0.001) at one year and 92.25 ± 13 (P < 0.001) at 5 years. The etiology showed that most (52.63%) of our patients had primary osteoarthritis with Type 3 acetabular defect. Two (5.26%) patients had the following complications: dislocation (2.63%) and screw breakage (2.63%). The minimum follow‑up period was 5 years. Discussion: After follow‑up at 1 year and 5 years, the hips showed significant improvement concerning pain, gait, and mobility based on HHS and were able to return to their various professions.

Conclusion: APC provides a satisfactory solution for patients who present with acetabular deficiency in complex primary THR.

Keywords: Acetabular defect, clinical outcome, complex primary total hip replacement, DePuy antiprotrusio cage