# Iliac Stemmed Cups: A Review of History, Indications, and Clinical Outcomes in Revision Hip Arthroplasty and Primary Severe Dysplasia

## TL;DR

This review discusses the use of iliac stemmed cups in hip replacement surgeries, focusing on their effectiveness in complex cases and outcomes over time.

## Contribution

The paper provides a comprehensive review of the evolution, clinical use, and outcomes of iliac stemmed cups in hip arthroplasty.

## Key findings

- ISCs have evolved from monobloc to modular designs, improving surgical versatility and stability.
- Complication rates for ISCs range from 10% to over 30%, with newer implants showing improved outcomes.
- Modular implants like the Sansone cup have demonstrated complication rates below 10% and five-year survival rates over 95%.

## Abstract

Background: The increasing incidence of revision total hip arthroplasties (rTHAs), particularly due to failure of the acetabular components and severe bone loss, necessitates reliable surgical solutions. Iliac stemmed cups (ISCs) have emerged as effective options for managing complex pelvic defects, including Paprosky type 3A and 3B acetabular defects, severe developmental dysplasia, and selected pelvic discontinuities. This review examines the historical evolution, clinical indications, and outcomes associated with ISCs. Methods: This narrative review analyzed the historical and recent literature concerning various ISC designs. We critically assessed clinical outcomes, complication rates, and implant survival from 13 key studies. Results: ISCs have progressed significantly from initial monobloc designs to contemporary modular configurations, substantially enhancing surgical versatility and biomechanical stability. Clinical outcomes varied with reported complications such as infection, dislocation, mechanical failure, and aseptic loosening ranging from 10% to over 30%. Newer modular implants like the Sansone cup have demonstrated improved outcomes, with complication rates below 10% and five-year survival rates exceeding 95%. Conclusions: ISCs are reliable and versatile implants, particularly suited to address significant pelvic bone deficiencies. Optimal surgical techniques and careful implant selection remain essential to minimize complications and achieve favorable long-term functional outcomes, making these implants valuable tools in complex hip arthroplasty.