10-Year Survival of Acetabular Reinforcement Rings/Cages for Complex Hip Arthroplasty

Alexander Ewers, Christian Spross, Lukas Ebneter, Fabrice Külling, Karlmeinrad Giesinger, Vilijam Zdravkovic, Johannes Erhardt*
Department of Orthopaedics and Traumatology, Kantonsspital St. Gallen, Switzerland

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© Ewers et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Kantonsspital St. Gallen, Rorschacherstrasse 95, 9007 St. Gallen, Switzerland; Tel: +41 71 494 1402; E-mail:


Introduction :

Acetabular reinforcement rings/ cages (AR) are commonly used for reconstruction of bone defects in complex hip arthroplasty. The aim of this study was to retrospectively investigate the 10-year survival rate of Ganz reinforcement rings and Burch-Schneider cages used in a single institution.

Material and Methods :

Between September 1999 and June 2002 all ARs, implanted in one institution, were identified. All patients had regular clinical and radiographic follow-up and were included in this study. Their prospectively collected clinical and radiographic data was retrospectively analyzed. In case of death before the 10-year follow-up examination, patient’s families or their general practitioner was contacted by telephone. The main outcome measures were survival of the ARs and kind of revision surgery.

Results :

The 10-year survival rate was 77.7%. At 10-year follow-up, 5/60 (8,3%) patients could not be located and had to be excluded therefore. 27/55 (49,1%) were dead, whereof 22 had no revision of the ARs before death (after a mean of 66 months; range: 0 - 123). Of the remaining 28/55 (50,9%) patients, 23 patients (24 ARs) had no revision of the ARs.

Conclusion :

Despite the high mortality rate of this study’s collective, ARs for complex primary or revision total hip arthroplasty provided predictable long term results.

Level of Evidence :

Clinical investigation.

Keywords: Acetabular reinforcement ring/cage, acetabular revision. Burch-Schneider Cage, Ganz Ring, Implant survival.