Comparative analysis of current 3D printed acetabular titanium implants

Dall’Ava, Lorenzo; Hothi, Harry; Henckel, Johann; Laura, Anna Di; Shearing, Paul R.; Hart, Alister

doi:10.1186/s41205-019-0052-0

Cited by 33 publications

(18 citation statements)

References 24 publications

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“…Two-stage revision remains the gold standard for the treatment of deep periprosthetic hip infection [19]. Performing revision surgery on the hip joint in patients with severe defects in the acetabulum, especially those with pelvic discontinuity, remains a challenge for surgeons [20]. It is worth noting that the purpose of the spacer is not only to treat infection but also to improve the function of the joint.…”

Section: Discussionmentioning

confidence: 99%

The potential for 3D technology to be used in the first-stage periprosthetic hip joint infection treatment

Мурылев¹,

Kukovenko²,

Елизаров³

et al. 2021

Preprint

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Background. In two-stage deep periprosthetic infection treatment, many authors describe mechanical complications associated with the implantation of a spacer in the first stage that affect the functional outcome of the treatment.Purpose. To evaluate the functional results of using 3D spacers for IIIA and IIIB defects according to the classification system described by W.G. Paprosky during the first stage treatment of hip deep periprosthetic joint infection (PJI).Methods. From 2017 to 2020, 24 patients underwent first-stage revision arthroplasty with hip PJI and IIIA and IIIB acetabular bone defects according to the classification system described by W.G. Paprosky. The patients were divided into 2 groups: group 1 received articulating spacers, and group 2 received custom-made spacers made using 3D technology. Function was evaluated by the Harris Hip Score, WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index) and VAS (visual analogue scale). Statistical analyses were performed using IBM SPSS Statistics version 22.0 for Windows. Student's t-test, Wilcoxon's signed-rank test (to compare parameters before and after surgery) and the Mann-Whitney rank-sum test were used.Results. In the first group, the average VAS score was 3.3 (± 1.4), the Harris Hip Score was 51.3 (± 9.4), and the WOMAC score was 42.9 (± 5.9); in the second group, the VAS score was 1.3 (± 0.9), the Harris Hip Score was 69.7 (± 3.6), and the WOMAC score was 30.1 (± 2.4). The rating scale data showed a statistically significant improvement in the function of patients in the second group (p <0.05).Conclusion. Custom-made 3D spacers used during the first stage of treatment for deep periprosthetic hip infection yield larger improvements in function and quality of life than do articulating spacers.Trial registration. Local Ethics Committee at the Sechenov First Moscow State Medical University Ministry of Health of Russia (Sechenov University) № 386 13.12.2016.

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Section: Discussionmentioning

confidence: 99%

The potential for 3D technology to be used in the first-stage periprosthetic hip joint infection treatment

Мурылев¹,

Kukovenko²,

Елизаров³

et al. 2021

Preprint

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“…The investigators reported that the wall thickness, together with the highly porous surface, contributed to 3D cup stability, allowing peripheral micromotion of the sockets, and at the same time, provided rigidity with the thicker walls[ 11 ]. Dall’Ava et al [ 12 ] evaluated the outer surfaces of three off-the -shelf 3D printed titanium cups (Delta TT, Trident II Tritanium, and Mpact 3D Metal). The three cups have differences as wall thickness, pore size, porosity, and metallic structure.…”

Section: Preclinical Studiesmentioning

confidence: 99%

“…The three cups have differences as wall thickness, pore size, porosity, and metallic structure. Some molten beads were present, with differences of size and density related to the production technology[ 12 ]. Dall’Ava et al [ 13 ] compared 3D printed cups (Delta TT) with conventional cups (Pinnacle Porocoat, DePuy, United States).…”

Section: Preclinical Studiesmentioning

confidence: 99%

“…To date, the optimal 3D printing technique is still unknown. The 3D printed cups that have been evaluated in preclinical studies differ in pore size, porosity and structure, and some features that are dependent on the manufacturing method[ 12 ]. Moreover, while additive manufacturing is a highly efficient method with up to a 50% reduction of production costs and up to a 75% reduction of raw material use, the fine balance between efficiency and quality is yet to be determined[ 8 , 9 , 36 ].…”

Section: Open Questions and Future Developmentsmentioning

confidence: 99%

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Off-the-shelf 3D printed titanium cups in primary total hip arthroplasty

Castagnini¹,

Caternicchia²,

Biondi³

et al. 2021

WJO

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Three-dimensional (3D)-printed titanium cups used in primary total hip arthroplasty (THA) were developed to combine the benefits of a low elastic modulus with a highly porous surface. The aim was to improve local vascularization and bony ingrowth, and at the same time to reduce periprosthetic stress shielding. Additive manufacturing, starting with a titanium alloy powder, allows serial production of devices with large interconnected pores (trabecular titanium), overcoming the drawbacks of tantalum and conventional manufacturing techniques. To date, 3D-printed cups have achieved dependable clinical and radiological outcomes with results not inferior to conventional sockets and with good rates of osseointegration. No mechanical failures and no abnormal ion release and biocompatibility warnings have been reported. In this review, we focused on the manufacturing technique, cup features, clinical outcomes, open questions and future developments of off-the-shelf 3D-printed titanium shells in THA.

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“…3D-printing enables the design and production of complex structures and optimized cup sizes, but its potential risks and clinical impact are still poorly understood [11].…”

Section: Introductionmentioning

confidence: 99%

Characterization of dimensional, morphological and morphometric features of retrieved 3D-printed acetabular cups for hip arthroplasty

et al. 2020

Self Cite

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Background: Three-dimensional (3D) printing of porous titanium implants is increasing in orthopaedics, promising enhanced bony fixation whilst maintaining design similarities with conventionally manufactured components. Our study is one of the first to non-destructively characterize 3D-printed implants, using conventionally manufactured components as a reference. Methods: We analysed 16 acetabular cups retrieved from patients, divided into two groups: '3D-printed' (n = 6) and 'conventional' (n = 10). Coordinate-measuring machine (CMM), electron microscopy (SEM) and microcomputed tomography (micro-CT) were used to investigate the roundness of the internal cup surface, the morphology of the backside surface and the morphometric features of the porous structures of the cups, respectively. The amount of bony attachment was also evaluated. Results: CMM analysis showed a median roundness of 19.45 and 14.52 μm for 3D-printed and conventional cups, respectively (p = 0.1114). SEM images revealed partially molten particles on the struts of 3D-printed implants; these are a by-product of the manufacturing technique, unlike the beads shown by conventional cups. As expected, porosity, pore size, strut thickness and thickness of the porous structure were significantly higher for 3D-printed components (p = 0.0002), with median values of 72.3%, 915 μm, 498 μm and 1.287 mm (p = 0.0002). The median values of bony attachment were 84.9% and 69.3% for 3D-printed and conventional cups, respectively (p = 0.2635). Conclusion: 3D-printed implants are designed to be significantly more porous than some conventional components, as shown in this study, whilst still exhibiting the same shape and size. We found differences in the surface morphologies of the groups, related to the different manufacturing methods; a key finding was the presence of partially molten particles on the 3D-printed cups.

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Comparative analysis of current 3D printed acetabular titanium implants

Cited by 33 publications

References 24 publications

The potential for 3D technology to be used in the first-stage periprosthetic hip joint infection treatment

The potential for 3D technology to be used in the first-stage periprosthetic hip joint infection treatment

Off-the-shelf 3D printed titanium cups in primary total hip arthroplasty

Characterization of dimensional, morphological and morphometric features of retrieved 3D-printed acetabular cups for hip arthroplasty

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