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  • Title: Technical factors for success with metal ring acetabular reconstruction.
    Author: Udomkiat P, Dorr LD, Won YY, Longjohn D, Wan Z.
    Journal: J Arthroplasty; 2001 Dec; 16(8):961-9. PubMed ID: 11740749.
    Abstract:
    Sixty-four hips in 62 patients were revised with a Mueller ring (28 hips), Ganz ring (18 hips), and Burch-Schneider cage (18 hips) under the direction of a single surgeon. A polyethylene cup was cemented into the metal support of all hips. Average follow-up was 4.6 years (range, 2.0-6.7 years). Six rings were revised because of aseptic loosening, and 5 others were radiographically loose, for a mechanical failure rate of 11 of 64 (17%). Acetabular metal ring supports failed by migration when defects of > or =60% of the superior weight-bearing bone were filled by only cement or particulate graft. At the time of surgery, the superior rim of the metal support should be against host-bone for 60% of its support, and if not, the use of bulk allograft, rather than particulate graft, is required. Dislocation was the second failure mechanism identified, and this occurred in 15 hips (23%), with reoperation required in 5 hips (8%). A constrained liner should be used in patients with nonunion of the trochanter and preoperative abductor weakness that grades fair/minus or worse as measured by the side-lying abduction test.
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