Long-Term Results of Anti-Protrusio Cage and Massive Allografts for the Management of Periprosthetic Acetabular Bone Loss

From 1992 to 1995, 71 total hip arthroplasties with extensive acetabular bone loss underwent revision using bulk allografts and Burch-Schneider anti-protrusio cages. Twelve patients died of unrelated causes and 3 were lost to follow-up. Fifty-six hips were available for clinical and radiographic follow-up examination at an average of 11.7 years after surgery. The average final Harris hip score was 75. X-ray signs of incorporation of massive bone graft were observed in 49 hips. Two cases developed deep infection that required resection arthroplasty. Aseptic loosening of the acetabular cage occurred in 5 patients, and 2 of them underwent re-revision. With a total survival rate of 87.5%, anti-protrusio cages and structural allografts compare favorably with other techniques in the long-term reconstructive treatment of extensive loss of acetabular bone stock.