[Acetabular metastatic defect reconstruction using the modular revision support cup MRS-C].

Area of Science:

• Orthopedic oncology
• Reconstructive surgery
• Biomaterials engineering

Context:

• Metastatic acetabular defects pose significant challenges in oncological patients.
• Current treatment options often focus on palliative care, with limited focus on functional restoration.
• Advanced cancer stages necessitate innovative solutions for skeletal reconstruction and patient mobility.

Purpose:

• To evaluate the efficacy of a bone cement-augmented revision support cup for stabilizing metastatic acetabular defects.
• To assess the impact of this surgical technique on the remobilization and quality of life in oncological patients.
• To determine the implant survivability and functional outcomes in patients with advanced cancer.

Summary:

• Fourteen patients with metastatic acetabular defects (MAC 2-4) and medium-to-long-term survival prognosis underwent acetabular reconstruction using a cement-augmented revision support cup.
• The surgical technique involved curettage, reaming, cement augmentation, and implant insertion, followed by modular inlay or dual mobility system.
• Postoperative management included weight-bearing as tolerated, adjuvant radiation, and continued systemic therapy, with a mean Harris Hip Score improvement of 23.2 and a mean survival of 9.7 months.

Impact:

• The study highlights the potential of cement-augmented revision support cups to improve functional outcomes and enable remobilization in oncological patients with acetabular metastases.
• The implants demonstrated high survivability (13/14) in this challenging patient population, suggesting a favorable risk-benefit profile.
• This approach offers a viable option for improving the quality of life for patients with advanced cancer and skeletal involvement.