Cup and Cage Reconstruction for Metastatic Acetabular Lesions Provides Functional Improvement and Cost-efficiency

Abstract

Pathologic acetabular lesions have multiple surgical options proposed and no clearly defined optimal solution at this time. In this study, we present our cage and cup reconstruction method and analyze postoperative outcomes against previously published studies. Twenty-four patients from 2014 to 2020 with acetabular pathologic lesions treated with an antiprotrusio cage and cup reconstruction were identified. Patient charts were reviewed for operative time, blood loss, Musculoskeletal Tumor Society functional scores, follow-up, and complications. The average blood loss was 727 mL, and the average postoperative Musculoskeletal Tumor Society score was 70.3, with an average improvement of 35.2 points from preoperative scores. The average cost of our construct per year was $1177 for patients surviving >1 year after surgery. Eleven (45%) patients had died of disease at an average survival time of 14.2 months. Our study compares well with historic reconstruction strategies for metastatic acetabular disease, showing that this cup/cage reconstruction provides a durable and perioperatively safe approach that provides functional improvement while remaining cost-efficient. Level IV.