Background:

A number of papers have been published about the clinical performance of modern rough-blasted titanium Burch-Schneider antiprotrusio cages (BS-APCs) for the treatment of acetabular bone defects. However, no systematic review of the literature has been published to date.

Methods:

The US National Library of Medicine (PubMed/MEDLINE), EMBASE, and the Cochrane Database of Systematic Reviews were queried for publications using keywords pertinent to Burch-Schneider antiprotrusio cage, revision THA, and clinical outcomes.

Results:

8 articles were found to be suitable for inclusion in the present study in which 374 cases (370 patients) had been treated with modern BS-APCs. Most acetabular bone defects were type 3 according to the Paprosky classification (type 2C: 18.1%, 3A: 51%, and 3B: 28.9%). The overall re-revision rate for the 374 acetabular reconstructions with modern BS-APCs was 11.5% (43 cases). The short-term survival rate of the modern BS-APC construct was 90.6% (339 out of 374 cases), while the mid-term survival rate was 85.6% (320 out of 374 cases), and the long-term survival rate 62% (54 out of 87 cases). The most common reasons for revision were aseptic loosening (5.6%), periprosthetic joint infection (3.8%), dislocation (2.7%), and acetabular periprosthetic fracture (1.9%).

Conclusions:

There was moderate quality evidence to show that the use of modern rough blasted titanium BS-APCs in cases of acetabular bone loss has an unacceptably high failure rate (38%). Given that antiprotrusio cages do not provide any biological fixation, we would not recommend the routine use of modern BS-APCs in complex revision THA cases. By contrast, the satisfactory short- to mid-term outcome of modern BS-APCs in combination with their low cost compared to highly porous acetabular implants, make us feel that BS-APCs might still be used in selected elderly or low-demand patients without severe superomedial acetabular bone loss.

中文翻译：

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用于治疗髋臼缺陷的现代 Burch-Schneider antiprotrusio 保持架：它仍然是一种选择吗？系统评价

背景：

已发表多篇关于现代粗糙喷砂钛 Burch-Schneider 抗突出保持架 (BS-APC) 治疗髋臼骨缺损的临床表现的论文。然而，迄今为止尚未发表对文献的系统评价。

方法：

使用与 Burch-Schneider antiprotrusio 笼、修订 THA 和临床结果相关的关键字查询美国国家医学图书馆 (PubMed/MEDLINE)、EMBASE 和系统评价 Cochrane 数据库的出版物。

结果：

发现 8 篇文章适合纳入本研究，其中 374 例（370 名患者）接受了现代 BS-APC 治疗。根据 Paprosky 分类，大多数髋臼骨缺损为 3 型（2C 型：18.1%，3A：51%，3B：28.9%）。使用现代 BS-APC 进行的 374 例髋臼重建的总体再翻修率为 11.5%（43 例）。现代 BS-APC 结构的短期存活率为 90.6%（374 例中的 339 例），而中期存活率为 85.6%（374 例中的 320 例），长期存活率为 62 %（87 例中的 54 例）。最常见的翻修原因是无菌性松动（5.6%）、假体周围感染（3.8%）、脱位（2.7%）和髋臼假体周围骨折（1.9%）。

结论：

有中等质量的证据表明，在髋臼骨丢失病例中使用现代粗喷钛 BS-APC 的失败率高得令人无法接受（38%）。鉴于 antiprotrusio 笼子不提供任何生物固定，我们不建议在复杂的翻修 THA 病例中常规使用现代 BS-APC。相比之下，现代 BS-APCs 令人满意的中短期结果，以及与高孔髋臼植入物相比成本低廉，使我们认为 BS-APCs 仍可用于选定的老年或低需求患者，而无需严重的上内侧髋臼骨丢失。