Clinical and radiographic outcomes of a trabecular titanium™ acetabular component in hip arthroplasty: results at minimum 5 years follow-up (original) (raw)
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The Journal of arthroplasty, 2015
Titanium-based highly-porous metal cups have been introduced as a relatively new alternative for enhanced acetabular fixation during revision THA; limited number of studies have evaluated its outcomes. We aimed to assess the clinical, functional, and patient-reported outcomes following the use of new generation highly-porous titanium acetabular implants in the revision setting. Seventy-one revisions were (1:1) matched to a conventional porous-coated cohort and were followed-up clinically and radiographically for at least 2-years. Non-significant differences in overall aseptic-survivorship were found across all types of acetabular defects comparing both cohorts (P=0.3). The overall HHS, UCLA, and SF-36 scores were similar between both cohorts. It remains to be seen if the great potential for enhanced osseointegration translates into improved long-term survivorship compared to conventional-porous devices.
Use of Trabecular Titanium Implants for Primary Hip Arthroplasty
Ortopedia Traumatologia Rehabilitacja, 2016
Wstęp.Aloplastyka całkowita stawu biodrowego jest procedurą wykonywaną coraz częściej. W dużej liczbie przypadków nieuchronnie znajdują się pacjenci, u których mimo pierwotnego charakteru zabiegu niezbędne jest uzupełnienie ubytków kostnych panewki stawu biodrowego. Stosowane w tych przypadkach przeszczepy kostne auto-i alogenne oraz pierścienie oporowe wymagają długiego odciążania, aby umożliwić wgojenie przeszczepów. Częściowo wady tej pozbawione są wypełnienia wykonane z porowatego tytanu. Celem pracy jest przedstawienie naszych wyników zastosowania uzupełnień z porowatego tytanu w aloplastykach pierwotnych. Materiał i metody. Do badania włączono grupę 23 chorych (18 kobiet i 5 mężczyzn), którym w latach 2010-2015 w Krakowskim Centrum Rehabilitacji i Ortopedii w czasie pierwotnej aloplastyki stawu biodrowego wszczepiono implant z porowatego tytanu. Wyniki. W średnim okresie obserwacji zanotowano poprawę w zmodyfikowanej i tradycyjnej skali Harris'a oraz redukcję dolegliwości bólowych w skali VAS. Nie zanotowano obluzowania ani infekcji implantu. Zastosowanie porowatego tytanu pozwoliło zmniejszyć liczbę koniecznych do użycia przeszczepów kostnych. Wnioski. 1.Uzupełnienie ubytków panewki implantami z porowatego tytanu może być stosowane w aloplastykach pierwotnych stawu biodrowego z dobrym wynikiem klinicznym i radiologicznym. 2. Zastosowanie uzupełnień z porowatego tytanu pozwala zmniejszyć liczbę przeszczepów kostnych niezbędnych do uzupełnienia ubytków panewki i pozwala na natychmiastowe, częściowe obciążanie kończyny. Słowa kluczowe: porowaty tytan, całkowita aloplastyka stawu biodrowego, ubytek panewki SUMMARY Background. Total hip arthroplasty is an increasingly common procedure. The large number of cases inevitably includes patients who require filling of their acetabular defect even in their primary surgery. The use of a utogenous grafts and allografts as well as resistance rings requires patients to avoid loading the limb for a long time to enable implant integration. This disadvantage may be partially eliminated by using trabecular titanium implants. The aim of this paper is to present the outcomes of the use of trabecular titanium implants in primary hip arthroplasty. Material and methods. The study embraced 23 patients (18 women and 5 men) whose primary hip arthroplasty was performed in the Cracow Centre of Rehabilitation and Orthopaedics in the period 2010-2015 and involved placement of a trabecular titanium implant. Results. Medium-term follow-up revealed improvement according to the modified and traditional Harris Hip Score and reduction in pain according to VAS. Loosening of the implant or infection were not recorded. The use of trabecular titanium allowed for reducing the amount of bone grafts used. Conclusions. 1. Reconstruction of acetabular defects with trabecular titanium implants may be used in primary hip arthroplasty to produce good clinical and radiographic outcomes. 2. The use of trabecular titanium implants allows for reducing the amount of bone grafts necessary to fill the acetabular defect and enables immediate partial loading of the limb.
Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association, 2018
The use of 3-dimensional highly porous acetabular cups is increasing. Their structure and mechanical properties mimic those of natural bone; therefore, they should promote stronger biological fixation. In our experience with total hip arthroplasty, radiolucent lines are observed when a 3-dimensional highly porous cup (Stryker Tritanium) is used. We compared the clinical and radiographic results between a Tritanium cup and a conventional cup (Stryker Trident HA) over a short time period. We retrospectively compared consecutive cases of primary total hip arthroplasty using a Tritanium cup (130 cases in 118 patients) and a matched cohort using a Trident cap (130 cases in 130 patients) between January 2011 and December 2014. The mean follow-up duration was 41.3 and 38.1 months (p = 0.06) for the Tritanium and Trident groups, respectively. There were significant differences between the groups for radiolucent lines, cup abduction angle, and cup-center-edge angle. There were no significant...
Hip international : the journal of clinical and experimental research on hip pathology and therapy, 2017
Trabecular Titanium is an advanced cellular solid structure, composed of regular multiplanar hexagonal interconnected cells that mimic the morphology of the trabecular bone. This biomaterial demonstrated improved mechanical properties and enhanced osteoinduction and osteoconduction in several in vitro and in vivo studies. The aim of this study was to assess Trabecular Titanium osseointegration by measuring periacetabular changes in bone mineral density (BMD) with dual-emission X-ray absorptiometry (DEXA). 89 patients (91 hips) underwent primary total hip arthroplasty (THA) with acetabular Trabecular Titanium cups. Clinical (Harris Hip Score (HHS), SF-36) and radiographic assessment were performed preoperatively, and postoperatively at 7 days and at 3, 6, 12 and 24 months. DEXA analysis was performed only postoperatively, using the BMD values measured at 7 days as baselines. After an initial decrease from baseline to 6 months, BMD increased and progressively stabilised in all 3 regio...
The results of the titanium-coated RM acetabular component at 20 years
The Journal of Bone and Joint Surgery. British volume, 2008
In a prospective study, 93 unselected consecutive uncemented hip arthroplasties were performed in 80 patients using the titanium-coated RM acetabular component and the CLS femoral component. The mean age of the patients at operation was 52 years (28 to 81). None were lost to follow-up. In the 23 patients who had died (26 hips) only one acetabular component had been revised. In the 57 living patients (67 hips), 13 such revisions had been performed. Of the 14 revisions, seven were for osteolysis, five for loosening and two for infection. Survival analysis of this implant showed a total probability of survival of 83% (95% confidence interval 73 to 90), with all revisions as the endpoint, and a probability of 94% (95% confidence interval 87 to 98) with revision for aseptic loosening as the endpoint, indicating reliable long-term fixation of the titanium-coated RM acetabular component.
Howse II cemented titanium metal-backed acetabular cups Poor 10-year results in 107 hips
Acta Orthopaedica, 2003
We report a retrospective clinical and radiographic review of 107 consecutive primary total hip replacements, using the cemented Howse II prosthesis. The review concentrates on the long-term performance of the acetabular cup, which was designed with a cylindrical titanium metal backing and a polyethylene liner. In all the hips in the series, this cup was used with a modular titanium straight femoral stem and a 32-mm diameter titanium head. At a mean follow-up of 9.8 (7-11) years, 28 hips had already been revised and 10 others were recognized as clinical or radiographic failures. The indication for revision in 26 of the hips was aseptic loosening and the mean time to revision was 7.2 (3.7-10.9) years This metal-backed cup has only 42% survival at 10 years, which seems to be related to certain of its design features. These include an inadequate thickness of polyethylene sterilized by gamma irradiation in air, a lack of mechanical bonding between the liner and its metal shell, and the high wear rate from the use of a 32-mm titanium femoral head.
Acetabular revision arthroplasty using trabecular titanium implants
International Orthopaedics, 2014
Purpose The aim of this study was to evaluate early results of acetabular revisions of total hip replacement using fully cementless trabecular titanium (TT) acetabular modular implants (Delta Trabecular Titanium, Limacorporate, Udine, Italy). Methods Between March 2009 and May 2012 TT was used in 81 revisions. The mean age at the time of revision was 68 years (32-84 years). There were nine patients revised for type 1, 11 for type 2A, 27 for type 2B, six for type 2C, 15 for type 3A and 13 for type 3B acetabular defects according to the Paprosky classification. Frozen morselised bone allografts were used in 53 cases and bulk structural allografts in three cases. Clinical evaluations were made using a modified functional Merle d'Aubigné-Postel score. The mean follow-up period was 38.14 months (24-62 months). Results The mean pre-operative Merle d'Aubigné-Postel functional score was 4.7 and 9.8 at the time of last followup. There was one revision due to instability of the acetabular component. A cage system-Delta Revision TT-was successfully used in this case. Three cases with Paprosky type 3B defect showed cranial migration of the acetabular component by 6 mm, but stabilised after six months. No dislocations associated with acetabular surgery have occurred in the cohort. There have been no dissociations of the modular component. A fatigue fracture of the hemispherical module occurred in the revised case. No other hardware mechanical failures have been recorded. Conclusions TT cups, hemispherical modules and augments facilitate reliable and reproducible biological fixation in acetabular revision surgery with excellent results. Extended follow-up is necessary to evaluate the long-term performance of TT modular implants.
HIP International, 2019
Introduction: Titanium cages are valuable implant solutions in management of severe acetabular defects during total hip revisions. We aimed to report clinical and radiological results of our cases in which we used titanium cages for reconstruction of acetabular defects. Methods: Patients underwent titanium cage reconstruction and bone grafting for their acetabular defects with minimum 2 year-follow-up are included to the study. Analysis of patient records, modified Hospital for Special Surgery hip score and radiological examinations on plain X-rays were evaluated. Acetabular defects are classified according to Paprosky’s classification. Kaplan Meier survival analysis is performed. Results: Fifty-six hips of 54 patients (2 bilateral) aged between 29-79 (mean 57 years ) are followed up for 7.06 years ±3.72 (2-17 years). Five patients required revision surgeries at a mean of 2.6±2.2 years. Kaplan Meier’s analysis revealed a survival rate of 91,5 % and mean revision free duration was 15...
Trabecular metal acetabular components in primary total hip arthroplasty
Acta orthopaedica, 2018
Background and purpose - Trabecular metal (TM) cups have demonstrated favorable results in acetabular revision and their use in primary total hip arthroplasty (THA) is increasing. Some evidence show that TM cups might decrease periprosthetic infection (PPI) incidence. We compared the survivorship of TM cups with that of other uncemented cups in primary THA, and evaluated whether the use of TM cups is associated with a lower risk of PPI. Patients and methods - 10,113 primary THAs with TM cup and 85,596 THAs with other uncemented cups from 2 high-quality national arthroplasty registries were included. The mean follow-up times were 3.0 years for the TM cups and 3.8 years for the other uncemented cups. Results - The overall survivorship up to 8 years for TM cups and other uncemented cups was 94.4% and 96.2%, respectively (p = < 0.001). Adjusting for relevant covariates in a Cox regression model the TM cups had a persistently higher revision risk than other uncemented cups (HR =1.5, 9...