Acetabular revision arthroplasty using trabecular titanium implants

Abstract

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.

Bioactive treatment promotes osteoblast differentiation on titanium materials fabricated by selective laser melting technology

“…Ideally, the porous surface and the main body of the implant should be fabricated integrally as one piece. For this purpose, additive manufacturing methods with metal powders have been recently introduced to the field of orthopedics, and hip implants fabricated by electron beam melting are already in clinical use 2) . Selective laser melting (SLM) technology [3][4][5] is one of the additive manufacturing methods available for the formation of metal implants.…”

Use of Trabecular Titanium Implants for Primary Hip Arthroplasty

“…Wymienione właściwości porowatego tytanu spowodowały, że wykonane z niego panewki oraz uzupełnienia znalazły szerokie i efektywne zastosowanie w aloplastykach rewizyjnych [15][16][17][18][19][20]. W związ-ku z tak dobrymi wynikami zastosowania porowatego tytanu w realoplastykach postanowiliśmy użyć go również w zabiegach pierwotnych, w których niezbędne było uzupełnienie ubytków kotnych panewki.…”

“…Due to the above properties of trabecular titanium, titanium acetabula and implants have been widely and effectively used in revision arthroplasty [15][16][17][18][19][20]. In view of such positive outcomes of trabecular titanium use for revision arthroplasty, we decided to employ it in those primary procedures where it was necessary to fill acetabular defects.…”

Tritanium acetabular wedge augments: short-term results

“…Due to lack of resources, the initial treatment for these types of defects was structural allografts (5,6). Later on, newer technology allowed the use of cages (7,8), jumbo cups (9-11), and most recently, acetabular augments have been added to our armamentarium (12,13). All these treatment options have been used for filling acetabular defects, but consensus for superiority of one method over others has not been reached.…”

“…Following cage reconstruction, there can be increased bone loss and structural failure (16), and elevation of the center of rotation can occur after using jumbo cups (17,18). Previous studies have reported on the use and outcomes of trabecular metal acetabular augments for the reconstruction of acetabular defects (13). However, no study has been conducted evaluating augmentation of acetabular defects using tritanium acetabular wedge augments.…”