The Burch-Schneider antiprotrusio cage in revision hip arthroplasty with acetabular bone defect

Background. This article presents early outcome of revision hip arthroplasties with massive defects of acetabular bone stock using the Burch-Schneider (B-S) antiprotrusio cage. Materials and methods. We prospectively followed 28 hips in 27 patients (17 women and 10 men). The average age of the patients was 68 years (range 40-82). Follow-up ranged from 12 to 53 months (ave. 25 months). Combined bone loss (type III according to the AAOS classification) was the most common (75% of the patients). Bone grafts (morselized and solid) were used to reconstruct deficient acetabula in 25 hips. Results. The patients were satisfied with the surgical result. The mean Harris Hip Score increased 36 points one year after operation and reached 80 points (range 56-93). The antiprotrusio cages were stable in all hips, even in 4 cases of inferior flange malposition. We found no measurable implant migration or graft resorption in any patient. Postoperative dislocation occurred in 3 hips (11%), two of them developed recurrent dislocations. There were no deep infections. Conclusions. Acetabular reconstruction using the Burch-Schneider antiprotrusio cage can be successfully used in managing massive acetabular defects in revision hip arthroplasty. The cage provides the basis for bone repair and protects grafts from excessive stress. Postoperative dislocation is the most common complication.