Abstract
BackgroundAim of this prospective study was to evaluate mid-term clinical and radiographic outcomes in total hip arthroplasty using an acetabular cup made of an innovative biomaterial, Trabecular Titanium™, whose highly porous structure and mechanical properties have been designed to mimic those of the natural bone, thus promoting a more physiological load transfer and a more durable fixation.MethodsBetween September 2007 and November 2009, 134 total hip replacements and eight revisions were carried out using DELTA-TT primary cups (Lima Corporate, Villanova di San Daniele del Friuli, Italy) in 133 consecutive patients. Mean age was 57.5 ± 14.7 SD (18–92) years. Diagnosis was primarily hip osteoarthritis in 85 (63 %) cases, developmental dysplasia of the hip (DDH) in 24 (18 %) and hip avascular necrosis (AVN) in 10 (7 %). All the revision procedures were due to aseptic loosening of the original implant. Approval of the Institutional Review Board of the IRCCS Policlinico San Matteo in Pavia was obtained for this study.ResultsMean follow-up was 72.7 ± 7.9 SD (60–86) months. Average Harris Hip Score (HHS) significantly increased from 44.2 ± 5.4 SD (35–52) preoperatively to 95.9 ± 3.5 SD (88–100) at the last follow-up. No major post-operative complications were observed. 99.3 % of the acetabular components were radiographically stable at the last follow-up, without any radiolucent lines, sclerotic areas or periprosthetic osteolysis. Kaplan-Meier survival rate was 99.3 % at 5 years (95 % confidence interval).ConclusionsThis first account on the mid-term clinical performance of the DELTA-TT cup shows primary and secondary stability, thus representing an optimal solution for patients with high demands or affected by severe hip conditions.
Highlights
Aim of this prospective study was to evaluate mid-term clinical and radiographic outcomes in total hip arthroplasty using an acetabular cup made of an innovative biomaterial, Trabecular TitaniumTM, whose highly porous structure and mechanical properties have been designed to mimic those of the natural bone, promoting a more physiological load transfer and a more durable fixation
The patients needed to be assessed as difficult Total hip arthroplasty (THA) cases in order to be included in this series, such as subjects affected by severe hip conditions, patients with high demands or extremely poor bone quality according to the patient’s age and X-ray evaluation, or patients requiring hip revision surgery but presenting limited bone deficiency (i.e. Paprosky I or IIA)
No differences were observed in terms of clinical results and survivorship among the three major diagnoses (i.e. OA, avascular necrosis (AVN) and developmental dysplasia of the hip (DDH))
Summary
Aim of this prospective study was to evaluate mid-term clinical and radiographic outcomes in total hip arthroplasty using an acetabular cup made of an innovative biomaterial, Trabecular TitaniumTM, whose highly porous structure and mechanical properties have been designed to mimic those of the natural bone, promoting a more physiological load transfer and a more durable fixation. THA has been continuously evolving in the past years in terms of prosthetic designs and materials, surgical techniques, treatment and prevention of complications and patient postoperative management. Press-fit techniques, bone-implant apposition, pore size and material properties play a major role in promoting bone ingrowth and long-term fixation [2,3,4]. Trabecular TitaniumTM is a highly porous cellular solid structure, designed with multi-planar hexagonal interconnected cells to mimic the trabecular morphology of the natural. Trabecular TitaniumTM has shown osteoinductive and osteconductive properties in various in vitro and animal studies, where it has demonstrated to stimulate vascularisation as well as osteoblast proliferation and differentiation [12–15]
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