Table 1.
Characteristics of the spacers and their mechanical complications reported by the studies included in this review
| Study | Year | Spacer design | Number of spacers | Mean age (year) | Metallic core | Mean spacer duration (months, approximated) | Mechanical complications, n. (%) | Spacer fracture, n. (%) | Perispacer fracture, n. (%) | Spacer dislocation, n. (%) | Acetabular complications, n. (%) |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Buller et al.[22] | 2021 | Standardized—preformed | 28 | 61.6 | None | 3.2 | 0 | 0 | 0 | 0 | 0 |
| Burastero et al. [23] | 2017 | Standardized—preformed | 71 | 67.4 | Steel reinforcement rod | NA | 7 (9.9%) | 1 (1.4%) | 1 (1.4%) | 5 (7.0%) | 0 |
| Cabrita et al.[2] | 2007 | Manually shaped | 37 | 54.6 | None | NA | 6 (16.2%) | 1 (2.7%) | 0 | 3 (8.1%) | 2 (5.4%) |
| Cai et al. [24] | 2021 | Manually shaped | 38 | 67.5 | K-wires or femoral stem |
24 temporary (N/A) 14 indefinite |
4 (10.5%) | 0 | 2 (5.3%) | 2 (5.3%) | 0 |
| Erivan et al.[13] | 2017 | Manually shaped | 26 | 71 | K-wires and/or Steinmann pins / None | 3 | 24 (92.3%) | 5 (19.2%) | 5 (19.2%) | 11 (42.3%) | 3 (11.5%) |
| Hsieh et al.[25] | 2004 | Manually shaped | 58 | 59 | K-wires | 3.1 | 3 (5.2%) | 2 (3.4%) | 0 | 1 (1.7%) | 0 |
| Jung et al.[16] | 2009 | Standardized—moulded | 88 | 70 | None | 3 | 36 (40.9%) | 9 (10.2%) | 12 (13.6%) | 15 (17.0%) | 0 |
| Koo et al. [26] | 2001 | Standardized—moulded | 22 | 56 | None | 1.5–4 | 1 (4.5%) | 0 | 1 (4.5%) | 0 | 0 |
| Lancaster et al. [27] | 2020 | Standardized—preformed | 58 | 59.8 | Femoral stem | NA | 11 (19.0%) | 5 (8.6%) | 2 (3.4%) | 4 (6.9%) | 0 |
| Leuning et al.[15] | 1998 | Manually shaped | 12 | 60 | Plates. screws | 4 | 7 (58.3%) | 1 (8.3%) | 0 | 5 (41.7%) | 1 (8.3%) |
| Magnan et al.[17] | 2001 | Standardized—preformed | 10 | 71.8 | Steel reinforcement rod | 5 | 3 (30.0%) | 0 | 0 | 1 (10.0%) | 2 (20.0%) |
| Molinas et al.[28] | 2017 | Standardized—preformed | 71 | 70 | Steel reinforcement rod | NA | 8 (11.3%) | 0 | 0 | 8 (11.3%) | 0 |
| Petis et al.[29] | 2017 | Manually shaped | 17 | 78.5 | None | > 24 | 6 (35.3%) | 0 | 1 (5.9%) | 1 (5.9%) | 4 (23.5%) |
| Pizzo et al.[30] | 2020 | Manually shaped | 15 | 64.5 | None | 3.3 | 0 | 0 | 0 | 0 | 0 |
| Shin et al. [31] | 2002 | Manually shaped | 8 | N/A | Femoral stem | NA | 0 | 0 | 0 | 0 | 0 |
| Yang et al.[32] | 2019 | Standardized—moulded | 31 | 56 | K-wires | 3.3 | 14 (45.2%) | 3 (9.7%) | 4 (12.9%) | 7 (22.6%) | 0 |
| Zhang et al.[33] | 2020 | Manually shaped | 13 | 59.7 | K-wires | 5.2 | 12 (92.3%) | 5 (38.5%) | 1 (7.7%) | 3 (23.1%) | 3 (23.1%) |
| 10 | 61.1 | Femoral stem | 4.2 | 6 (60.0%) | 0 | 0 | 3 (30.0%) | 3 (30.0%) | |||
| 13 | 64.7 | ACP + polyethylene sockets | 9 | 2 (15.4%) | 0 | 1 (7.7%) | 1 (7.7%) | 1 (7.7%) | |||
| Abendschein et al.[34] | 1992 | Manually shaped | 1 | N/A | None | 1.1 | 0 | 0 | 0 | 0 | 0 |
| Takahira et al.[35] | 2003 | Manually shaped | 8 | 67.1 | Ender nail/K-wires with cerclage wires | 1.5–4.4 | 0 | 0 | 0 | 0 | 0 |
| Fink et al.[36] | 2008 | Manually shaped | 36 | 69 | Femoral stem | 1.5 | 1 (2.8%) | 0 | 0 | 1 (2.8%) | 0 |
| Pattyn et al.[38] | 2011 | Standardized—preformed | 61 | 65.4 | Steel reinforcement rod | 1.7 | 11 (18.0%) | 0 | 1 (1.6%) | 10 (16.4%) | 0 |
| D'angelo et al. [38] | 2011 | Standardized—preformed | 28 | 71.4 | Steel reinforcement rod | 1.3 | 3 (10.7%) | 0 | 0 | 3 (10.7%) | 0 |
| Romanò et al.[8] | 2012 | Standardized—preformed | 183 | 60.3 | Steel reinforcement rod | 4 | 35 (19.1%) | 0 | 5 (2.7%) | 30 (16.4%) | 0 |
| Jones et al.[6] | 2019 | Standardized—moulded | 30 | 64 | Steel reinforcement rod | 3.2 | 23 (76.7%) | 7 (23.3%) | 12 (40.0%) | 4 (13.3%) | 0 |
| Manually shaped | 97 | Various steel reinforcement rods | 6 (6.2%) | 2 (2.1%) | 1 (1.0%) | 3 (3.1%) | 0 | ||||
| 56 | ACP + polyethylene sockets | 11 (19.6%) | 0 | 5 (8.9%) | 6 (10.7%) | 0 | |||||
| Standardized—preformed | 2 | Steel reinforcement rod | 0 | 0 | 0 | 0 | 0 | ||||
| Bori et al. [18] | 2013 | Standardized—preformed | 74 | 72.4 | Steel reinforcement rod | 1.2 | 8 (10.8%) | 0 | 0 | 8 (10.8%) | 0 |
| Duncan et al.[39] | 1993 | Standardized—preformed | 15 | N/A | Steel reinforcement rod | 1–9.2 | 3 (20.0%) | 0 | 0 | 3 (20.0%) | 0 |
| Ivarsson et al. [40] | 1994 | Manually shaped | 5 | 69.4 | None | 0.7–2 | 2 (40.0%) | 0 | 1 (20.0%) | 1 (20.0%) | 0 |
| Younger et al. [10] | 1997 | Standardized—preformed | 61 | 67 | Steel reinforcement rod | 1.2–9.7 | 6 (9.8%) | 0 | 1 (1.6%) | 5 (8.2%) | 0 |
| Durbhakula et al. [41] | 2004 | Standardized—moulded | 20 | 69.8 | Rush pin | 2.3–4.8 | 4 (20.0%) | 2 (10.0%) | 0 | 2 (10.0%) | 0 |
| Barrack et al.[9] | 2002 | Manually shaped | 12 | N/A | Rush pin | 1.5–4 | 0 | 0 | 0 | 0 | 0 |
| Deshmukh et al. [42] | 1998 | Manually shaped | 5 | N/A | Küntcher nail | NA | 0 | 0 | 0 | 0 | 0 |
| McGrory et al. [43] | 2002 | Manually shaped | 1 | N/A | Endoprosthetic head | NA | 0 | 0 | 0 | 0 | 0 |
| Isiklar et al.[44] | 1999 | Manually shaped | 10 | N/A | Steinmann pins | 0.7–3.2 | 2 (20.0%) | 1 (10.0%) | 0 | 1 (10.0%) | 0 |
| Jahoda et al.[45] | 2003 | Manually shaped | 29 | N/A | K-wires | 1.5–6.4 | 7 (24.1%) | 2 (6.9%) | 0 | 5 (17.2%) | 0 |
| Kraay et al.[46] | 1992 | Manually shaped | 7 | N/A | Cerclage wire | NA | 0 | 0 | 0 | 0 | 0 |
| Morimoto et al. [47] | 2003 | Manually shaped | 1 | 16 | Gamma locking nail | 1.5 | 0 | 0 | 0 | 0 | 0 |
| Yamamoto et al. [48] | 2003 | Standardized—moulded | 17 | 61.8 | K-wires | 4.3 | 2 (11.8%) | 1 (5.9%) | 0 | 1 (5.9%) | 0 |
| Zilkens et al.[49] | 1990 | Standardized—preformed | 1 | 71 | Metallic telescopic shaft | 6 | 0 | 0 | 0 | 0 | 0 |
| Wentworth et al. [50] | 2002 | Standardized—preformed | 135 | N/A | Steel reinforcement rod | NA | 15 (11.1%) | 0 | 0 | 15 (11.1%) | 0 |
| Faschingbauer et al. [14] | 2015 | Standardized—moulded | 93 | 69.3 | Stainmann pin / None | NA | 13 (14.0%) | 12 (8.7%) | 2 (1.4%) | 12 (8.7%) | 1 (0.7%) |
| Manually shaped | 45 | 14 (31.1%) | |||||||||
| Total | – | – | 1659 | – | – | – | 316 (19.0%) | 59 (3.5%) | 58 (3.5%) | 180 (10.8%) | 20 (1.2%) |