Allogeneic cancellous bone graft and a Burch-Schneider ring for acetabularreconstruction in revision hip arthroplasty

Background: There is an ever-increasing number of failed hip arthroplasties associated with massive deficiency of acetabular bone stock consisting of a segmental or cavitary defect. This study was undertaken to evaluate the l ong-term results after use of morselized cryopreserved allogeneic bone graf t and an antiprotrusio cage to treat such a deficiency. Methods: From January 1, 1988, to January 1, 1994, forty-one patients (fort y-one hips) with an acetabular defect classified as type III or IV accordin g to the American Academy of Orthopaedic Surgeons system were operated on w ith use of a Burch-Schneider ring and morselized cryopreserved allogeneic c ancellous bone graft. Thirty-eight patients (thirty-eight hips) were availa ble for clinical and radiographic follow-up examinations at an average of 7 .3 years (range, 4.2 to 9.4 years) after surgery. Results: All measured clinical parameters had improved significantly by the time of the follow-up examination (p < 0.0001). Radiographs confirmed that none of the thirty-eight hips had any measurable migration or displacement of the acetabular component and that osseous consolidation occurred only w ithin the grafted area in all patients. Conclusion: Acetabular reconstruction with use of morselized cryopreserved allogeneic cancellous bone graft and the Burch-Schneider ring can be highly successful in managing massive acetabular deficiencies in revision hip art hroplasty.