Acetabular reconstruction with the Burch-Schneider ring: an EBRA analysis of 40 cup revisions. 2006

Thomas Ilchmann, and Jan Philipp Gelzer, and Eugen Winter, and Kuno Weise
Department of Orthopedics, Kantonsspital Liestal, Switzerland. thomas.ilchmann@ksli.ch

BACKGROUND Reconstruction of the bone stock and fixation of the implant remain challenging problems in revision surgery. In this retrospective study, we wanted to gain information on initial stability and wear after revision with the Burch-Schneider ring. METHODS Between 1994 and 1998, we performed 70 reconstructions of the acetabulum with a Burch-Schneider ring in revision arthroplasty. 63 patients could be followed up clinically and radiographically. 40 cups were suitable for EBRA measurements whereas migration and wear could not be assessed by this method in 23 cases due to lack of comparability of pelvic radiographs. The mean follow-up time was 4.7 years. RESULTS 2 cups were re-revised and 14 cups had breakage or changes of position of the screws. 30 cups showed detectable migration and 18 cups detectable wear. The mean migration was 2.8 mm and the mean wear rate was 0.12 mm/year. 16 cups had detectable migration after 1 year; 11 of these 16 continued to migrate and 9 of them had screw breakage. Both re-revisions showed early migration. Early migration correlated with later screw breakage and the overall migration correlated with wear. The only risk factor found for early migration was the wear rate. CONCLUSIONS The Burch-Schneider ring is an established and reliable implant for cup revision with good clinical results, but it seems to be difficult to maintain intraoperative stability. The implants with continuous migration may lead to late clinical failure and require further observation. Wear may contribute to migration and resorption of the bone graft.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009984 Orthopedic Fixation Devices Devices which are used in the treatment of orthopedic injuries and diseases. Device, Orthopedic Fixation,Devices, Orthopedic Fixation,Fixation Device, Orthopedic,Fixation Devices, Orthopedic,Orthopedic Fixation Device
D011474 Prosthesis Design The plan and delineation of prostheses in general or a specific prosthesis. Design, Prosthesis,Designs, Prosthesis,Prosthesis Designs
D011475 Prosthesis Failure Malfunction of implantation shunts, valves, etc., and prosthesis loosening, migration, and breaking. Prosthesis Loosening,Prosthesis Durability,Prosthesis Migration,Prosthesis Survival,Durabilities, Prosthesis,Durability, Prosthesis,Failure, Prosthesis,Failures, Prosthesis,Loosening, Prosthesis,Loosenings, Prosthesis,Migration, Prosthesis,Migrations, Prosthesis,Prosthesis Durabilities,Prosthesis Failures,Prosthesis Loosenings,Prosthesis Migrations,Prosthesis Survivals,Survival, Prosthesis,Survivals, Prosthesis
D011859 Radiography Examination of any part of the body for diagnostic purposes by means of X-RAYS or GAMMA RAYS, recording the image on a sensitized surface (such as photographic film). Radiology, Diagnostic X-Ray,Roentgenography,X-Ray, Diagnostic,Diagnostic X-Ray,Diagnostic X-Ray Radiology,X-Ray Radiology, Diagnostic,Diagnostic X Ray,Diagnostic X Ray Radiology,Diagnostic X-Rays,Radiology, Diagnostic X Ray,X Ray Radiology, Diagnostic,X Ray, Diagnostic,X-Rays, Diagnostic
D012086 Reoperation A repeat operation for the same condition in the same patient due to disease progression or recurrence, or as followup to failed previous surgery. Revision, Joint,Revision, Surgical,Surgery, Repeat,Surgical Revision,Repeat Surgery,Revision Surgery,Joint Revision,Revision Surgeries,Surgery, Revision
D005260 Female Females
D005271 Femur Head Necrosis Aseptic or avascular necrosis of the femoral head. The major types are idiopathic (primary), as a complication of fractures or dislocations, and LEGG-CALVE-PERTHES DISEASE. Aseptic Necrosis of Femur Head,Avascular Necrosis of Femur Head,Necrosis, Aseptic, of Femur Head,Necrosis, Avascular, of Femur Head,Avascular Necrosis Of Femoral Head, Primary,Femoral Head, Avascular Necrosis Of,Ischemic Necrosis Of Femoral Head,Femur Head Necroses,Head Necrosis, Femur,Necrosis, Femur Head
D005500 Follow-Up Studies Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease. Followup Studies,Follow Up Studies,Follow-Up Study,Followup Study,Studies, Follow-Up,Studies, Followup,Study, Follow-Up,Study, Followup

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