Original Articles
Reconstruction of segmental defects during revision procedures of the acetabulum with the Burch-Schneider anti-protrusio cage*,**

https://doi.org/10.1054/arth.2001.23919Get rights and content

Abstract

Abstract: Sixty-three Burch-Schneider rings in 62 patients with segmental or combined defects were followed up after a mean of 5.45 years. The mean Harris hip score was 74.9 points. Aseptic loosening occurred in 3 cases, and septic loosening occurred in 2 cases. All cases of aseptic loosening had Paprosky stage IIIb defects and defects of the posterior column. Radiologic migration analysis showed increased migration with increase in the Paprosky defect stage, defects of the posterior column, and cranial defects. The cage has the lowest migration and loosening rate in cases with medial defects or anterior column defects. Surgical treatment of defects of the posterior column is associated with an increased rate of aseptic loosening, whereas implantation with cranial defects shows a higher migration rate with no significant increase in loosening.

Section snippets

Materials and methods

A total of 79 revision operations of acetabular components were performed in 75 patients using the Burch-Schneider cage. Patients with segmental or combined bone defects were included in the study. Patients undergoing primary procedures, patients with isolated cavitary defects, patients with septic exchange, and patients with tumors or metastases in the region of the operation were excluded from the study. The mean follow-up period was 5.45 years (range, 36-120 months). A total of 62 patients

Perioperative procedure

A total of 79 Burch-Schneider cages were implanted in 75 patients. According to Paprosky's definition [1], 3 patients (3.9%) had stage IIa defects, 23 (30.3%) had stage IIb defects, 33 (43.4%) had stage IIc defects, 5 patients (6.6%) had stage IIIa defects, and 12 patients (15.6%) had stage IIIb defects.

Specific risk factors were confirmed osteoporosis in 12 cases (15.2%), renal osteopathy in 4 cases (5.1%), peripheral occlusive arterial disease on the side of the operation in 4 case (5.1%), a

Discussion

Comparison of the results of revision arthroplasty of the hip joint is difficult [16]. Various implants have been recommended for extensive bone defects of the acetabulum, such as bipolar prostheses 17, 18, 19, eccentric prostheses 20, 21, 22, oversized cups [23], support rings 9, 24, and individual implants, frequently with additional use of bone transplantation. No single implant is suitable for treating the whole spectrum of defects, however, The surgical procedure must be selected according

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  • Cited by (0)

    *

    No benefits or funds were received in support of this study.

    **

    Reprint requests: Carsten Perka, MD, Orthopädische Klinik und Poliklinik der Charité, Schumannstraβe 20/21, 10098 Berlin, Germany. E-mail: [email protected]

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