The iliac stemmed cup in reconstruction of the acetabular defects secondary to tumor resection: a systematic review of literature

Introduction Stemmed acetabular cups are suitable for reconstruction in case of important bone loss. Nevertheless, their use is not so common, because generally judged very invasive and technically difficult to implant. The aim of the present review is to verify the results of their use and to evaluate indications and complications. Materials and methods Literature research was performed in the main healthcare databases; indications, surgical technique, related complications, functional results and implant survival were valued and analyzed for every selected paper. Results 13 studies were selected, for a population of 424 patients and 428 hips. The main indication was reconstruction after tumor removal; the primary non-oncologic indication was revision for aseptic loosening. The most frequent complications were aseptic loosening and implant failure (16.2%), followed by deep infection (11.3%) and dislocation (9.8%). The average MSTS score was 65.9%; while data regarding functional results for degenerative cases are quite fragmented. The 5-years implant survival was 73.6%. Conclusions Data regarding SAC prostheses are quite rare in the literature; no prospective studies with comparisons with other reconstruction techniques are available so their use is mainly based on the experience of single centers. While data for tumors are more consistent and supported by studies, information on revisions of hip prosthesis implanted for degenerative problems is quite scarce. Preliminary results on the SAC prosthesis as a valid alternative both for tumoral and degenerative revision cases are encouraging. Prospective randomized studies are advocated to value results compared to alternative techniques.

Automated summary

This review examined the use of stemmed acetabular cups for reconstruction and the associated complications. The main indications for these cups were post-tumor removal reconstruction and revision for aseptic loosening. The most common complications were aseptic loosening and implant failure. Limited data on functional results for degenerative cases were available, but preliminary results suggest that stemmed acetabular cups are a promising alternative for both tumor and degenerative revision cases.