Primary total hip replacement using Burch-Schneider cages for acetabular fractures

Introduction: Osteoporotic acetabular fractures are common and pose a difficult technical challenge for the trauma surgeon. Acute total hip arthroplasty (THA) using a Burch-Schneider antiprotrusio cage with immediate postoperative weight-bearing is a method to approach these injuries. This case seri...

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Bibliographic Details
Published in:Hip international 2022-05, Vol.32 (3), p.401-406
Main Authors: Liaw, Frank, Govilkar, Siddharth, Banks, Daniel, Kankanalu, Pradeep, Youssef, Bishoy, Lim, Justin
Format: Article
Language:English
Subjects:
Acetabulum - diagnostic imaging
Acetabulum - injuries
Acetabulum - surgery
Aged
Aged, 80 and over
Arthroplasty, Replacement, Hip - adverse effects
Follow-Up Studies
Hip Fractures - diagnostic imaging
Hip Fractures - etiology
Hip Fractures - surgery
Hip Prosthesis
Humans
Middle Aged
Prosthesis Failure
Radiography
Reoperation
Retrospective Studies
Treatment Outcome
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Summary:Introduction: Osteoporotic acetabular fractures are common and pose a difficult technical challenge for the trauma surgeon. Acute total hip arthroplasty (THA) using a Burch-Schneider antiprotrusio cage with immediate postoperative weight-bearing is a method to approach these injuries. This case series reports our outcomes of acute THA using Burch-Schneider cages for acetabular fractures from a UK major trauma centre based on length of stay, radiological outcome, complications and outcome scores. Methods: Data were collected from all patients who underwent acute THA with a Burch-Schneider cage for acetabular fractures between June 2006 and August 2015. Patients were followed up clinically, radiologically, and using Oxford Hip Scores (OHS). Results: 20 patients with a median age of 73 (range 60–90 years) were identified. All patients were independent walkers at follow-up, and had achieved radiological union. There were no dislocations, subsidence, revision or deep infections. Significant complications include 1 perioperative death as a result of complications arising from pre-existing pulmonary fibrosis; 1 deep vein thrombosis; 1 intraoperative arterial injury to the superior gluteal artery; and 1 leg-length discrepancy. Mean length of stay was 10 days. The mean OHS was 37/48 at a mean follow-up of 26 months. Conclusions: This case series further validates the use of Burch-Schneider cages with primary THA in acute acetabular fractures.
ISSN:1120-7000
1724-6067
DOI:10.1177/1120700020957642