Skip to main content

Reinforcement Rings and Cages

  • Chapter
  • First Online:
  • 1019 Accesses

Abstract

Rings and cages are implants used in revision THA when the remaining bone stock is deficient. They span the bone defect and act as a scaffold while protecting morcellized or structural allograft during the bone remodeling phase [1]. The use of cages has been reduced over time following mechanical failure of cages and the introduction of newer techniques of trabecular metal components [1].

This is a preview of subscription content, log in via an institution.

References

  1. Sheth NP, Nelson CL, Springer BD, Fehring TK, Paprosky WG. Acetabular bone loss in revision total hip arthroplasty: evaluation and management. J Am Acad Orthop Surg. 2013;21:128–39.

    Article  PubMed  Google Scholar 

  2. Regis D. Acetabular reconstruction with the Burch-Schneider antiprotrusio cage and bulk allografts: minimum 10-year follow-up results. Biomed Res Int. 2014;9:194076.

    Google Scholar 

  3. Deirmengian GK, Zmistowski B, O’Neil JT, Hozack WJ. Management of acetabular bone loss in revision total hip arthroplasty gregory. J Bone Joint Surg Am. 2011;93:1842–52.

    Article  PubMed  Google Scholar 

  4. Starker M, Kandziora F, Jager A, Kerschbaumer F. Acetabular reconstruction using acetabular reinforcement rings. Orthopade. 1998;27:366–74.

    PubMed  CAS  Google Scholar 

  5. Daniel J. Berry antiprotrusio cages for acetabular revision. Clin Orthop. 2004;420:106–12.

    Article  Google Scholar 

  6. Pulido L, Rachala SR, Cabanela ME. Cementless acetabular revision: past, present, and future revision total hip arthroplasty: the acetabular side using cementless implants. Int Orthop. 2011;35:289–98.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Regis D, Sandri A, Bonetti I, Bortolami O, Bartolozzi P. A minimum of 10-year follow-up of the Burch-Schneider cage and bulk allografts for the revision of pelvic discontinuity. J Arthroplast. 2012;27(6):1057–1063.e1.

    Article  Google Scholar 

  8. Ilyas I, Alrumaih HA, Kashif S, Rabbani SA, Faqihi AH. Revision of type III and type IVB acetabular defects with Burch–Schneider antiprotrusio cages. J Arthroplast. 2015;30:259–64.

    Article  PubMed  Google Scholar 

  9. Gill TJ, Siebenrock K, Oberholzer R, Ganz R. Acetabular reconstruction in developmental dysplasia of the hip: results of the acetabular reinforcement ring with hook. J Arthroplast. 1999;14(2):131–7.

    Article  CAS  Google Scholar 

  10. Ewers A, Spross C, Ebneter L, Külling F, Giesinger K, Zdravkovic V, Erhardt J. 10-year survival of acetabular reinforcement rings/cages for complex hip arthroplasty. Open Orthop J. 2015;9:163–7.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Schlegel UJ, Bitsch RG, Pritsch M, Clauss M, Mau H, Breusch SJ. Mueller reinforcement rings in acetabular revision outcome in 164 hips followed for 2–17 years. Acta Orthop. 2006;77(2):234–41.

    Article  PubMed  Google Scholar 

  12. Regis D, Magnan B, Sandri A, Bartolozzi P. Long-term results of anti-protrusio cage and massive allografts for the management of periprosthetic acetabular bone loss. J Arthroplast. 2008;23(6):826–32.

    Article  Google Scholar 

  13. Angles AC-MF, Tramunt C, Casanova X. Burch-Schneider antiprotrusio cage for acetabular revision: a 5- to 13-year follow-up study. Hip Int. 2010;20(Suppl 7):S112–8.

    PubMed  Google Scholar 

  14. Abolghasemian M, SadeghiNaini M, Tangsataporn S, Lee P, Backstein D, Safir O, Kuzyk P, Gross AE. Reconstruction of massive uncontained acetabular defects using allograft with cage or ring reinforcement an assessment of the graft’s ability to restore bone M. Abolghasemian, stock and its impact on the outcome of re-revision. Bone Joint J. 2014;96:319–24.

    Article  PubMed  Google Scholar 

  15. Paprosky W, Sporer S, O’Rourke MR. The treatment of pelvic discontinuity with acetabular cages. Clin Orthop Relat Res. 2006;453:183–7.

    Article  PubMed  Google Scholar 

  16. Sembrano JN, Cheng EY. Acetabular cage survival and analysis of factors relatedto failure. Clin Orthop Relat Res. 2008;466:1657–65.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Ruatti S, Grimaldi M, Saragaglia D. Section of the sciatic nerve by a metal acetabulum reinforcement ring: a literature review through one case. Eur J Orthop SurgTraumatol. 2012;22(Suppl 1):S117–20.

    Article  Google Scholar 

  18. Berry DJ, Muller ME. Revision arthroplasty using an anti-protrusio cage for massive acetabular bone deficiency. J Bone Joint Surg Br. 1992;74(5):711.

    Article  CAS  PubMed  Google Scholar 

  19. Rosson J, Schatzker J. The use of reinforcement rings to reconstruct deficient acetabula. J Bone Joint Surg Br. 1992;74(5):716.

    Article  CAS  PubMed  Google Scholar 

  20. Zehntner MK, Ganz R. Midterm results (5.5–10 years) of acetabular allograft reconstruction with the acetabular reinforcement ring during total hip revision. J Arthroplast. 1994;9(5):469.

    Article  CAS  Google Scholar 

  21. Levai JP, Boisgard S. Acetabular reconstruction in total hip revision using a bone graft substitute. Early clinical and radiographic results. Clin Orthop Relat Res. 1996;330:108.

    Article  Google Scholar 

  22. Garbuz D, Morsi E, Gross AE. Revision of the acetabular component of a total hip arthroplasty with a massive structural allograft. Study with a minimum five-year follow-up. J Bone Joint Surg Am. 1996;78(5):693.

    Article  CAS  PubMed  Google Scholar 

  23. Schatzker J, Wong MK. Acetabular revision. The role of rings and cages. Clin Orthop Relat Res. 1999;369:187.

    Article  Google Scholar 

  24. Bohm P, Banzhaf S. Acetabular revision with allograft bone. 103 revisions with 3 reconstruction alternatives, followed for 0.3–13 years. Acta Orthop Scand. 1999;70(3):240.

    Article  CAS  PubMed  Google Scholar 

  25. van der Linde M, Tonino A. Acetabular revision with impacted grafting and a reinforcement ring: 42 patients followed for a mean of 10 years. Acta Orthop Scand. 2001;72(3):221.

    Article  PubMed  Google Scholar 

  26. Winter E, Piert M, Volkmann R, et al. Allogeneic cancellous bone graft and a Burch- Schneider ring for acetabular reconstruction in revision hip arthroplasty. J Bone Joint Surg Am. 2001;83(6):862.

    Article  PubMed  Google Scholar 

  27. Goodman S, Saastamoinen H, Shasha N, et al. Complications of Ilioischial reconstruction rings in revision total hip arthroplasty. J Arthroplast. 2004;19(4):436.

    Article  Google Scholar 

  28. Ilchmann T, Gelzer JP, Winter E, et al. Acetabular reconstruction with the Burch- Schneider ring: an EBRA analysis of 40 cup revisions. Acta Orthop. 2006;77(1):79.

    Article  PubMed  Google Scholar 

  29. Ochs BG, Schmid U, Rieth J, et al. Acetabular bone reconstruction in revision arthroplasty: a comparison of freeze-dried, irradiated and chemically-treated allograft vitalised with autologous marrow versus frozen non-irradiated allograft. J Bone Joint Surg Br. 2008;90(9):1164.

    Article  CAS  PubMed  Google Scholar 

  30. Gaiani L, Bertelli R, Palmonari M, et al. Total hip arthroplasty revision in elderly people with cement and Burch-Schneider anti-protrusio cage. La Chirurgiadegli organi di movimento. 2009;93(1):15.

    CAS  Google Scholar 

  31. Siebenrock KA, Trochsler M, Sadri H, et al. Hooked roof cup in revision of difficult loose hip prosthesis cups. Results after a minimum of 10 years. Der Orthopade. 2001;30(5):273.

    Article  CAS  PubMed  Google Scholar 

  32. Eggli S, Muller C, Ganz R. Revision surgery in pelvic discontinuity: an analysis of seven patients. Clin Orthop Relat Res. 2002;398:136.

    Article  Google Scholar 

  33. Gerber A, Pisan M, Zurakowski D, et al. Ganz reinforcement ring for reconstruction of acetabular defects in revision total hip arthroplasty. J Bone Joint Surg. 2003;85(12):2358.

    Article  PubMed  Google Scholar 

  34. Capone A, Setzu V, Ennas F, et al. Ganz reinforcement rings in acetabular revision: indications and medium-term results. La Chirurgiadegliorgani di movimento. 2004;89(2):107.

    CAS  Google Scholar 

  35. Uchiyama K, Takahira N, Fukushima K, et al. Radiological evaluation of allograft reconstruction in acetabulum with Ganz reinforcement ring in revision total hip replacement. J Orthop Sci. 2010;15(6):764.

    Article  PubMed  Google Scholar 

  36. Korovessis P, Spastris P, Sdougos G, et al. Acetabular roof reinforcement rings. Clin Orthop Relat Res. 1992;283:149.

    Google Scholar 

  37. Gurtner P, Aebi M, Ganz R. The acetabular roof cup in revision arthroplasty of the hip. Z Orthop Ihre Grenzgeb. 1993;131(6):594.

    Article  CAS  PubMed  Google Scholar 

  38. Pascarel X, Liquois F, Chauveaux D, et al. The use of Muller acetabular rings in revision surgery of total hip prosthesis. Apropos of 141 cases with a minimal 5-year follow-up. Rev Chir Orthop Reparatrice Appar Mot. 1993;79(5):357.

    PubMed  CAS  Google Scholar 

  39. Dihlmann SW, Ochsner PE, Pfister A, et al. Analysis of migration of screwed acetabular components following revision arthroplasty of the hip joint. Results of single-image roentgen analysis. Z Orthop Ihre Grenzgeb. 1994;132(4):286.

    Article  CAS  PubMed  Google Scholar 

  40. Stockl B, Beerkotte J, Krismer M, et al. Results of the Muller acetabular reinforcement ring in revision arthroplasty. Arch Orthop Trauma Surg. 1997;116(1-2):55.

    Article  CAS  PubMed  Google Scholar 

  41. Panski A, Tauber C. Acetabular supporting ring in total hip replacement. Arch Orthop Trauma Surg. 1997;116(4):233.

    Article  CAS  PubMed  Google Scholar 

  42. Beckmann NA, Weiss S, Klotz MCM, MatthiasGondan SJ, Bitsch RG. Loosening after acetabular revision: comparison of trabecular metal and reinforcement rings. A systematic review. J Arthroplast. 2014;29:229–35.

    Article  Google Scholar 

  43. Symeonides PP, Petsatodes GE, Pournaras JD, Kapetanos GA, Christodoulou AG, Marougiannis DJ. The effectiveness of the Burch-Schneider antiprotrusio cage for acetabular bone deficiency five to twenty-one years’ follow-up. J Arthroplast. 2009;24(2):168–74.

    Article  Google Scholar 

  44. Pieringer H, Auersperg V, Bfhler N. Reconstruction of severe acetabular bone-deficiency the Burch-Schneider antiprotrusio cage in primary and revision total hip arthroplasty. J Arthroplast. 2006;21(4):489–96.

    Article  Google Scholar 

  45. Kawanabe K, Akiyama H, Goto K, Maeno S, Nakamura T. Load Dispersion effects of acetabular reinforcement devices used in revision total hip arthroplasty. J Arthroplasty. 2011;26(7):1061–6.

    Article  PubMed  Google Scholar 

  46. Akiyama H, Yamamoto K, Tsukanaka M, Kawanabe K, Otsuka H, So K, Goto K, Nakamura T. Revision total hip arthroplasty using a Kerboull-type acetabular reinforcement device with bone allograft. J Bone Joint Surg Br. 2011;93:1194–200.

    Article  CAS  PubMed  Google Scholar 

  47. Rogers BA, Whittingham-Jones PM, Mitchell PA, Safir OA, Bircher MD, Gross AE. The reconstruction of periprosthetic pelvic discontinuity. J. Arthroplasty. 2012;27(8):1499–506.

    Article  PubMed  Google Scholar 

  48. Korzh NA, Filippenko VA, Mezentsev VA, Bondarenko SE. Reconstruction of acetabular defects in revision total hip arthroplasty. “Ars Medica” Traumatology and Orthopaedics. 2010;9(29):415–7.

    Google Scholar 

  49. Lachiewicz PF, Soileau ES. Fixation, survival, and dislocation of jumbo acetabular components in revision hip arthroplasty. J Bone Joint Surg Am. 2013;95(6):543–8.

    Article  PubMed  Google Scholar 

  50. Kim KC, Ha YC, Kang BJ, Lee YK, Ji HM, Koo KH. Use of cementless acetabular component with a hook and iliac flanges in revision arthroplasty for massive acetabular defect. J Orthop Sci. 2012;17(1):18–24.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding authors

Correspondence to Eleftherios Tsiridis M.D., Ph.D., F.A.C.S., F.R.C.S. , Thiago Aguiar , Rashid Tikhilov , Fritz Thorey , Volodymyr Filippenko M.D. or Georgios Petsatodis .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG, part of Springer Nature

About this chapter

Cite this chapter

Kenanidis, E. et al. (2018). Reinforcement Rings and Cages. In: Tsiridis, E. (eds) The Adult Hip - Master Case Series and Techniques. Springer, Cham. https://doi.org/10.1007/978-3-319-64177-5_27

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-64177-5_27

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-64175-1

  • Online ISBN: 978-3-319-64177-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics