Major Acetabular Defects Treated with the Burch-Schneider Antiprotrusion Cage and Impaction Bone Allograft in a Large Series: A 5- to 7- Year Follow-up Study

Marx, A.; Beier, Alexander; Richter, Anne; Lohmann, Christoph H.; Halder, Andreas M.

doi:10.5301/hipint.5000388

Cited by 16 publications

(33 citation statements)

References 41 publications

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“…And in our study, complete incorporation was encountered in 25 patients (89%), which achieved good outcome and seems better than Ding (79%) [17]. In previous studies, mid-term result of impaction bone grafting combining with cage showed the failure rate was 0–16% [8, 33, 37]. Recently, Akel et al reported a long-term result of this combination, the failure rate was 8.1% [38].…”

Section: Discussionmentioning

confidence: 49%

The mid-long term results of reconstructional cage and morselized allografts combined application for the Paprosky type III acetabular bone defects in revision hip arthroplasty

Xiao

Wang

Zhou

et al. 2019

BMC Musculoskelet Disord

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BackgroundSevere acetabular bone defects is a complex problem in revision hip arthroplasty, cage is one of the reconstruction options. The purpose of this study is to report the mid-long term clinical and radiographic results of Paprosky type III acetabular bone defects revised with reconstructional cage and morselized allogeneic cancellous bone graft without impaction.MethodsWe retrospectively analyzed 28 patients who underwent revision hip arthroplasty with reconstructional cage and allogeneic cancellous bone graft between January 2007 and January 2016. There were 13 Paprosky type IIIA bone defect patients and 15 Paprosky type IIIB bone defect patients and 4 patients of the 15 were also with pelvic discontinuity. Clinical assessment included Harris Hip Score (HHS) and Short Form-12 (SF-12). Radiographic assessment included center of rotation, cage migration, and bone graft incorporation.ResultsAll patients were followed up with a mean follow-up of 79.5 months (range 38–141), HHS improved from 31.4 (13–43) points preoperatively to 84.6 (55–94) points at last follow-up and SF-12 also improved significantly. There was 1 re-revision for the cage loosening and screw breakage at 61 months after surgery, and 2 patients had nonprogressive radiolucency in zone III and the junction of zone II and zone III at the bone implant interface.ConclusionThe reconstructional cage combining with morselized allografts without impaction achieves a good result with a high complete allograft incorporation rate in Paprosky type III acetabular bone defects.

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Section: Discussionmentioning

confidence: 49%

The mid-long term results of reconstructional cage and morselized allografts combined application for the Paprosky type III acetabular bone defects in revision hip arthroplasty

Xiao

Wang

Zhou

et al. 2019

BMC Musculoskelet Disord

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“…Pain levels were considerably reduced and-like in the present study-patients reported a good to excellent overall satisfaction with the surgical results. Re-revision rates were comparable with around 7% [13]. Ilyas et al reported a seven year mid-term follow-up of the classic Burch-Schneider reinforcement ring.…”

Section: Discussionmentioning

confidence: 75%

“…The augment-and-modular-cage system MRS-C has been CEmarked in 2014 and combines the principles of recent acetabular antiprotrusion cages (Ganz [4], Burch-Schneider [13,14]) with a variety of metal buttress augments.…”

Section: Implantmentioning

confidence: 99%

The augment-and-modular-cage revision system for reconstruction of severe acetabular defects—two-year clinical and radiographic results

Roessler

Jaenisch

Kuhlmann

et al. 2018

International Orthopaedics (SICOT)

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Purpose Acetabular revision of failed total hip arthroplasty (THA) is often associated with severe bone loss. Therefore, a variety of revision implant systems has been developed during recent years, with the augment-and-modular-cage system being one of the newest additions to this portfolio. Together with biologic downsizing by means of impaction bone grafting, this uncemented system promises a high modularity and versatility to treat all acetabular defects up to Paprosky types IIIa and IIIb without pelvic discontinuity. The aim of the present study was to evaluate first short-term results of its clinical application, both clinical functional and patient-reported as well as radiographic. Methods Forty-four patients (28 female, 16 male, mean age 70.9 ± 11.5 years) could be followed for a mean of 26 ± 10 months after acetabular revision with a novel augment-and-modular-cage system. Indications for revision included aseptic loosening (68%), septic loosening (16%), or others (16%) with bone loss Paprosky IIa up to IIIb without discontinuity. The modified Harris Hip Score (mHHS) served as a primary outcome parameter. In addition, a number of patient-reported outcome measurements (PROMs) were collected including the Short Form 36 (SF-36), Hip disability and Osteoarthritis Outcome Score (HOOS), and Visual Analogue Scale for Hip Pain (VAS Hip) as well as overall satisfaction. Radiographic changes between the pre-and postoperative center of rotation (COR) and various criteria of implant failure served as secondary outcome parameters. Results No patients were lost to follow-up. Two implant-associated complications (partial flange breakage) without a need for revision surgery were detected, which represent a failure rate of 4.5%. Functional outcome as measured by mHHS increased from 49.4 ± 2.9 pre-operatively to 74.4 ± 3.1 at the latest follow-up (p < 0.001). PROMs showed significant improvements in all painrelated categories, while other quality-of-life measurements only exhibited positive tendencies towards improvement. VAS Hip significantly improved from 6.5 ± 0.7 pre-operatively to 2.2 ± 0.6 at the latest follow-up (p < 0.001). Radiographic evaluation showed that reconstruction of the COR was possible, referenced to the contralateral side. The COR could be lateralized by 5.0 mm (n.s.) and caudalized by 10.3 mm (p < 0.001) comparing pre-operative and post-operative states, with complete osseointegration in 95% of the cases. Conclusions Treatment with the augment-and-modular-cage system significantly improved clinical functional and patientreported outcomes in cases of acetabular revision after failed THA. In addition, a good reconstruction of the COR could also be achieved. Therefore, this highly modular system can be considered as an effective treatment option in almost all cases of acetabular bone loss except for those of pelvic discontinuity. It offers the unique possibility of intra-operative implant customization according to the existing bone defect and host bone quality.

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“…32 Despite the limitation of few published clinical trials on the subject, radiation therapy and indomethacin have been investigated in many observational and longitudinal studies. [18][19][20][21][22][23][24][25] However, we observed that the results of these studies were also contradictory and should be interpreted with caution regarding the benefits and the risks of possible adverse effects, such as the risk of cancer when using radiation therapy and the risk of death from bleeding or gastric perforation, as well as pseudoarthrosis when using indomethacin. [18][19][20][21][22][23][24][25] As a strength of this review, we highlight the conduct of a comprehensive survey of randomized clinical trials in any language and with no restrictions on year of publication.…”

Section: Discussionmentioning

confidence: 90%

“…Then, we removed 41 duplicates and deleted 156 articles by screening titles and abstracts. We read 18 full articles, of which 13 were excluded: twelve studies had another type of design than a clinical trial, [18][19][20][21][22][23][24][25][26][27][28][29] and one presented patients from another research published and included in this article. 30 Of the total, five met the inclusion criteria (Figure 1).…”

Section: Resultsmentioning

confidence: 99%

Heterotopic Ossification in Acetabular Fractures: Systematic Review and Meta-Analysis of Prophylaxis

et al. 2021

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Objective: Heterotopic ossification is defined as the formation of trabecular bone in soft tissues. It is a common complication after surgical treatment of acetabular fractures. However, its prophylaxis and treatment are still controversial. The objective of this research is to evaluate the effectiveness of actions to prevent the development of heterotopic ossification after surgical correction of acetabular fractures. Methods: A systematic review was carried out with research in the databases PubMed/MEDLINE, Embase, LILACS and Cochrane until August 4, 2020, without restrictions on language and year of publication. Only randomized clinical studies carried out in humans without restrictions based on the dosage of treatments, use and duration of prophylaxis were included in this review. Results: Two studies compared the use of radiotherapy and indomethacin and three compared the use of indomethacin with a placebo or non-indomethacin group. The meta-analysis calculations did not indicate statistical differences between radiotherapy versus indomethacin (RR 1.45, IC 95% 0.97 to 2.17, p = 0,55) and indomethacin versus placebo or not indomethacin (RR 0.85, IC 95% 0.68 to 1.06, p = 0,59). Conclusion: There is insufficient evidence to affirm that the use of radiotherapy or indomethacin are effective to prevent the formation of heterotopic ossification after surgery for fractures of the acetabulum. In addition, the number of complications was higher in the indomethacin group when compared to placebo or no intervention. Level of Evidence I, Systematic Review.

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Major Acetabular Defects Treated with the Burch-Schneider Antiprotrusion Cage and Impaction Bone Allograft in a Large Series: A 5- to 7- Year Follow-up Study

Abstract: In a large consecutive series the Burch-Schneider anti-protrusion cage proved to be a valuable option in the treatment of major acetabular bone defects in hip revision surgery.

Cited by 16 publications

References 41 publications

The mid-long term results of reconstructional cage and morselized allografts combined application for the Paprosky type III acetabular bone defects in revision hip arthroplasty

The mid-long term results of reconstructional cage and morselized allografts combined application for the Paprosky type III acetabular bone defects in revision hip arthroplasty

The augment-and-modular-cage revision system for reconstruction of severe acetabular defects—two-year clinical and radiographic results

Heterotopic Ossification in Acetabular Fractures: Systematic Review and Meta-Analysis of Prophylaxis

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