A new 3D printing porous trabecular titanium metal acetabular cup for primary total hip arthroplasty: a minimum 2-year f
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(2020) 15:383
RESEARCH ARTICLE
Open Access
A new 3D printing porous trabecular titanium metal acetabular cup for primary total hip arthroplasty: a minimum 2-year follow-up of 92 consecutive patients Xiao Geng, Yang Li, Feng Li, Xinguang Wang, Ke Zhang, Zhongjun Liu and Hua Tian*
Abstract Background: 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. Few large sample studies have reported the clinical outcomes of electron beam melting (EBM) porous titanium acetabular cup in Chinese population. Methods: We 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. Results: HHS 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%). Conclusion: The 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. Keywords: Arthroplasty, Hip, 3D printing, Trabecular titanium acetabular cup, Outcome
Background Cementless acetabular cups have been utilized more and more common in total hip arthroplasty (THA) in recent years [1, 2]. Although 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]. Thus, surgeons and engineers have * Correspondence: [email protected] Department of Orthopaedics, Peking University Third Hospital, No. 49 North Garden Road, Beijing 100191, China
been working on prosthetic designs and materials for many years to improve the acetabular cups’ primary mechanical stability and secondary bone fixation [4–6]. The mechanical fixation and bone integration between the surface of the cup and the host bone interface are important factors to maintain initial and long-term stability of the cups [7, 8]. But it is technically limited because the traditional two-step porous coated cup surface cannot be designed integrated with the solid layer and optionally to achieve a
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