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Murylev V, Muzychenkov A, Elizarov P, Kukovenko G, Alekseev S, Zhuchkov AG, Erokhin NE. Long-term functional results of revision hip replacement using Burch-Schneider cages. J Orthop 2023; 37:53-58. [PMID: 36974092 PMCID: PMC10039112 DOI: 10.1016/j.jor.2023.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 02/09/2023] [Accepted: 02/16/2023] [Indexed: 03/29/2023] Open
Abstract
Introduction One of the most common and effective treatments for end-stage hip osteoarthritis is total hip arthroplasty (THA). According to the WHO, 1.5 million, more than 500,000, and approximately 100,000 THAs are performed annually in the world, in the USA, and in Russia, respectively. The use of Burch-Schneider cages has progressively increased since their introduction in 1975, with more than 125,000 cages being implanted by 2006. This design for revision surgery remains valid today.The objectives were to conduct a retrospective analysis of anti-protrusion cages in revision THA and evaluate long-term functional results. Methods Fifty-eight revision surgeries were performed at Botkin Hospital from 2003 to 2020 with anti-protrusion Burch-Schneider cages because of aseptic loosening of the acetabular component. The average age of the examined patients was 61.2 (±12.9) years. The maximum follow-up duration was 17 years. The average follow-up duration was 10.5 (±4.1) years. We used the functional Harris, WOMAC, SF-36, and FJS-12 scales to evaluate functional results. The patients were distributed into the following groups according to the Paprosky classification: 2C, 3A, and 3B. Results Group 2C showed good functional results, with a Harris score of 87 (±6.9), an FJS-12 score of 63.2 (±4.8), a WOMAC score of 175 (±16.7), and an Oxford Hip score of 39.06 (±9.1). Group 3A also showed good functional scores, with a Harris score of 78 (±7.1), an FJS-12 score of 61.2 (±5.1), a WOMAC score of 168 (±17.1), and an Oxford Hip score of 42.12 (±8.7). Group 3B showed satisfactory functional results, with a Harris score of 70 (±5.9), an FJS-12 score of 58.9 (±4.4), a WOMAC score of 166 (±18.1), and an Oxford Hip score of 48.4 (±9.4).Among patients who underwent revision surgery using Burch-Schneider rings, 16 needed to undergo repeat revision surgery. Periprosthetic infection occurred in 5 patients, aseptic loosening in 7, and periprosthetic fracture in 3. Conclusions The anti-protrusion Burch-Schneider system is a necessary and up-to-date element of THA and can be used with great efficacy in revision THA. Despite the rapid development of technologies and the appearance of new, highly efficient devices, there is still room for systems such as Burch-Schneider rings. However, there are relatively few indications for their use, with the main indications for the use of anti-protrusion systems being conditions related to bone defects of the acetabular roof and bone mass loss of the acetabular floor.
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Affiliation(s)
- Valeriy Murylev
- I.M.Sechenov First Moscow State Medical University (Sechenov University), Department of Traumatology, Orthopedics and Disaster Surgery, Moscow, 119991, Russian Federation
- S. P. Botkin Moscow City Clinical Hospital, Moscow City Arthroplasty Center, Moscow, 125284, Russian Federation
| | - Alexey Muzychenkov
- I.M.Sechenov First Moscow State Medical University (Sechenov University), Department of Traumatology, Orthopedics and Disaster Surgery, Moscow, 119991, Russian Federation
- S. P. Botkin Moscow City Clinical Hospital, Moscow City Arthroplasty Center, Moscow, 125284, Russian Federation
| | - Pavel Elizarov
- I.M.Sechenov First Moscow State Medical University (Sechenov University), Department of Traumatology, Orthopedics and Disaster Surgery, Moscow, 119991, Russian Federation
- S. P. Botkin Moscow City Clinical Hospital, Moscow City Arthroplasty Center, Moscow, 125284, Russian Federation
| | - Grigoriy Kukovenko
- I.M.Sechenov First Moscow State Medical University (Sechenov University), Department of Traumatology, Orthopedics and Disaster Surgery, Moscow, 119991, Russian Federation
- S. P. Botkin Moscow City Clinical Hospital, Moscow City Arthroplasty Center, Moscow, 125284, Russian Federation
| | - Semyon Alekseev
- S. P. Botkin Moscow City Clinical Hospital, Moscow City Arthroplasty Center, Moscow, 125284, Russian Federation
| | - Alexander G. Zhuchkov
- S. P. Botkin Moscow City Clinical Hospital, Moscow City Arthroplasty Center, Moscow, 125284, Russian Federation
| | - Nicolay E. Erokhin
- I.M.Sechenov First Moscow State Medical University (Sechenov University), Department of Traumatology, Orthopedics and Disaster Surgery, Moscow, 119991, Russian Federation
- S. P. Botkin Moscow City Clinical Hospital, Moscow City Arthroplasty Center, Moscow, 125284, Russian Federation
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Janko M, Verboket R, Genari M, Frank J, Marzi I. Primary or revision arthroplasty with an integrated acetabular cup-MUTARS ® RS cup system. Eur J Trauma Emerg Surg 2022; 48:4149-4155. [PMID: 35357517 PMCID: PMC9532320 DOI: 10.1007/s00068-022-01956-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 03/13/2022] [Indexed: 12/01/2022]
Abstract
INTRODUCTION The aim of this article is to show a new concept of indication and application of the MUTARS® RS Cup System in primary and revision hip arthroplasty. This integrated system is applicable for different acetabular cup replacements in patients with acetabular fractures or instable defects, as well as periprosthetic acetabular fractures. The MUTARS® RS Cup System is a cementless revision cup for insertion into the acetabulum with an integrated polyethylene cup, which fits to a regular or bipolar head. This system replaces the conventional approach for acetabular revision with a Burch-Schneider ring, in which a normal polyethylene cup is cemented. This interface with its complications is avoided with this system of a titanium revision cup with integrated polyethylene cup. Steps of preoperative planning and the intraoperative implementation will be highlighted in this article. MATERIAL AND METHODS This system was applied in 49 patients with 52 MUTARS® RS Cup Implantations in 30 males, 22 females, with an average age of 76,1 years (36,9-94,4 years). RESULTS AND DISCUSSION The system shows a good operative feasibility, as well as a reliable handling and safe method for stable treatment of non-reconstructable acetabular fractures or acetabular incongruencies and instabilities.
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Affiliation(s)
- Maren Janko
- Department of Trauma-, Hand- and Reconstructive Surgery, Goethe University Frankfurt, University Hospital, Frankfurt am Main, Germany.
| | - René Verboket
- Department of Trauma-, Hand- and Reconstructive Surgery, Goethe University Frankfurt, University Hospital, Frankfurt am Main, Germany
| | - Maria Genari
- Department of Trauma-, Hand- and Reconstructive Surgery, Goethe University Frankfurt, University Hospital, Frankfurt am Main, Germany
| | - Johannes Frank
- Department of Trauma-, Hand- and Reconstructive Surgery, Goethe University Frankfurt, University Hospital, Frankfurt am Main, Germany
| | - Ingo Marzi
- Department of Trauma-, Hand- and Reconstructive Surgery, Goethe University Frankfurt, University Hospital, Frankfurt am Main, Germany
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