Abstract
BackgroundAseptic cup loosening is still one of the main reasons leading to acetabular cup failures. 3D printing porous trabecular titanium metal acetabular cup may provide good initial stability and secondary fixation because of its highly interconnected, porous structure. Few large sample studies have reported the clinical outcomes of electron beam melting (EBM) porous titanium acetabular cup in Chinese population.MethodsWe retrospectively collected and analyzed the clinical data of a total of 92 consecutive patients between January 2013 and November 2017, with an average follow-up of 48.2 ± 3.6 months. Clinical outcomes included Harris Hip Score (HHS), the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index, satisfaction rate, and cup survival rate were evaluated. Radiographic assessments were conducted to evaluate osteointegration.ResultsHHS scores improved significantly while the WOMAC score decreased significantly at the latest follow-up (p < 0.001). The satisfaction rate (prevalence of satisfied or very satisfied) was 91.3%. No acetabular cup failures occurred. Radiolucent lines appeared in 15 cases (18 hips) and disappeared in 6 months. No cup loosening signs found until the last follow-up. The overall survival rate of implantation is 99.1% (cup survival rate 100%).ConclusionThe new EBM-produced 3D ACT™ cup demonstrated us its favorable short- to mid-term clinical outcomes in Chinese THA patients. It can provide high acetabular cup survival rate, great clinical improvements and excellent biological fixation. Further investigations are needed to confirm its long-term outcomes.
Highlights
Aseptic cup loosening is still one of the main reasons leading to acetabular cup failures. 3D printing porous trabecular titanium metal acetabular cup may provide good initial stability and secondary fixation because of its highly interconnected, porous structure
As the 3D printing technology widely applied to design various orthopedic implants, a few studies have showed excellent clinical and radiological outcomes and survivorship of the porous trabecular titanium metal acetabular component via electron beam melting (EBM), which is an important branch of 3D printing technology, especially when patients with poor bone quality in primary and revision total hip arthroplasty (THA) surgeries [10, 11]
General data After the approval of the Institutional Review Board was obtained for this study, we retrospectively collected the data from a total of 103 patients (120 hips) who underwent primary total hip arthroplasty used the 3D ACT porous titanium (Ti6Al4V) trabecular acetabular cups between January 2013 and November 2017
Summary
Aseptic cup loosening is still one of the main reasons leading to acetabular cup failures. 3D printing porous trabecular titanium metal acetabular cup may provide good initial stability and secondary fixation because of its highly interconnected, porous structure. Cementless acetabular cups have been utilized more and more common in total hip arthroplasty (THA) in recent years [1, 2] It has provided remarkably successful clinical outcomes in primary THAs, every year many cup failures, especially aseptic cup loosening, occur and lead to intractable revisions and heavy medical burdens [3]. As the 3D printing technology widely applied to design various orthopedic implants, a few studies have showed excellent clinical and radiological outcomes and survivorship of the porous trabecular titanium metal acetabular component via EBM, which is an important branch of 3D printing technology, especially when patients with poor bone quality in primary and revision THA surgeries [10, 11]. The EBM trabecular titanium has showed good osteoinductive and osteoconductive performances by a series of vitro and animal experiments [13,14,15]
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