Fifty-one prospectively followed Contour_ acetabular reconstruction cages, inserted through the direct lateral approach, were reviewed at three years minimum follow-up (range 3 to 6.4 yrs.). To date, four reoperations were required (two each for sepsis and instability) with no failures due to aseptic loosening. The Kaplan-Meier Survival Rate for any reoperation was 87% at 6.4 years. Short to mid-term follow-up of a single type of acetabular reconstruction cage, inserted through the lateral approach, demonstrated this to be a successful reconstruction option in the management of large acetabular bone defects. This study reports the mid-term results of a single design of acetabular reconstruction cage inserted through the direct lateral approach. At minimum three years follow-up (range 3 to 6.4 yrs.), there were no failures due to aseptic loosening with only four of fifty-one cases requiring reoperation (two sepsis, two instability). This review supports the use of the reconstruction cage, inserted through the lateral approach, for large defects that cannot be managed with a hemispherical porous implant. The use of the reconstruction cage in our center is reserved for large defects that cannot be managed with a hemispherical porous implant because of insufficient bone stock for initial implant stability and/or host bone contact for in-growth. Fifty-one consecutive prospectively followed Contour_ (Smith and Nephew) acetabular reconstruction cages, inserted through the direct lateral approach, were reviewed at three years minimum follow-up (range 3 to 6.4 yrs.). The majority of cases were AAOS Type Three and Four defects in which morsellized allograft was used in forty-nine cases and structural graft in three cases. Harris hip scores improved from 32.1±17.8 pre-op to 65.3±24.1 at most recent follow-up. Defining any acetabular reoperation as a failure, four of the fifty-one cages were considered to have failed giving a Kaplan-Meier Cumulative Survival Rate of 87% at 6.41 years. Two reoperations were for recurrent dislocation and the other two for sepsis. None of the fifty-one cages have been revised for aseptic loosening to date.
