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

Abstract

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.

Enhancing Hip Arthroplasty Outcomes: The Multifaceted Advantages, Limitations, and Future Directions of 3D Printing Technology

“…3D-printed titanium cups offer distinct advantages in orthopedic applications. These cups feature a porous and rough surface, theoretically promoting local vascularization and osseointegration while mitigating stress shielding due to their low elastic modulus [ 48 ]. Unlike other highly porous titanium cups produced through conventional methods, 3D-printed cups exhibit larger pore sizes and higher porosity, thereby replicating a trabecular bone-like elastic modulus.…”

“…The ability of additive manufacturing to integrate surface porosity within a monoblock implant is key to improving osseointegration and potentially reducing stress shielding by mimicking the stiffness of the periprosthetic bone [ 50 ]. It was shown that 3D-printed cups maintain acceptable micromotion, even surpassing conventional cups with lower wall thickness [ 48 ]. The combination of wall thickness and a highly porous surface contributes to the stability of 3D cups.…”