Burch-Schneider Ring Alone Vs Cup-Cage Construct in Massive Acetabular Bone Defect in Revision Total Hip Arthroplasty
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Published on: August 4, 2022
Sameh A Abdulall1, Mohamed A A Ibrahim1, Ahmed M Khairy1
1Orthopedic department, faculty of medicine Al-Azhar university, Cairo, Egypt.
Background:
In reconstructive orthopedic surgery, massive acetabular bone defects (ABD) in revision total hip arthroplasty (THA) remain a major problem. The purpose of this study was to evaluate and describe the clinical and radiological outcomes and complication profiles of the Burch-Schneider (BS) ring and Cup-Cage (C-C) construct in patients undergoing revision THA for massive acetabular bone defects, with each reconstruction used according to the presence or absence of pelvic discontinuity.
Methods:
In this prospective comparative study, 60 patients receiving revision THA for massive ABD were enrolled. Patients were allocated into two groups: 30 received a BS ring reconstruction, and 30 received a C-C construct. For an average of three years, each patient was monitored. Functional outcomes were evaluated by utilizing the Harris Hip Score (HHS), whereas radiological assessments concentrated on cup position, signs of aseptic loosening, and bone graft incorporation.
Results:
Both groups demonstrated significant postoperative improvements in HHS. However, the mean postoperative HHS was slightly higher in the C-C group than in the B-S group. Radiological evaluation revealed superior bone graft incorporation and a lower incidence of radiolucent lines in the cup-cage group. Furthermore, complications such as dislocation, infection, and mechanical loosening were observed more frequently in the BS group.
Conclusion:
Both the BS ring and the C-C construct were associated with improved clinical outcomes in appropriately selected patients with massive acetabular bone defects. The C-C construct may be useful in the management of pelvic discontinuity, whereas the BS ring remains an option when pelvic continuity is preserved. However, owing to the nonrandomized, indication-based treatment allocation and the limited sample size, these findings should not be interpreted as evidence of the superiority of one reconstruction technique over the other.