Carmine Zoccali1,2,3, Giuseppe Giannicola4, Giovanni Zoccali5, Elisa Checcucci6, Alessandra Scotto di Uccio7, Dario Attala6, Ciro Villani4. 1. Department of Anatomical, Histological, Forensic Medicine and Orthopaedic Science, University of Rome, Piazzale Aldo Moro 5, 00185, Rome, Italy. carminezoccali@libero.it. 2. Oncological Orthopaedics Department, IRCCS - Regina Elena National Cancer Institute, Via Elio Chianesi 53, Rome, Italy. carminezoccali@libero.it. 3. Orthopaedic and Traumatology Unit, Department of General Surgery, Plastic Surgery, Orthopedics, Policlinico Umberto I Hospital-Sapienza, University of Rome, Piazzale A. Moro 3, 00185, Rome, Italy. carminezoccali@libero.it. 4. Department of Anatomical, Histological, Forensic Medicine and Orthopaedic Science, University of Rome, Piazzale Aldo Moro 5, 00185, Rome, Italy. 5. Department of Plastic and Reconstructive Surgery, IRCCS - Regina Elena National Cancer Institute, Via Elio Chianesi 53, Rome, Italy. 6. Oncological Orthopaedics Department, IRCCS - Regina Elena National Cancer Institute, Via Elio Chianesi 53, Rome, Italy. 7. Hepato-Biliary and Organ Transplant Unit, School of General Surgery, Sapienza University, Viale del Policlinico 155, 00161, Rome, Italy.
Abstract
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.
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.
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