Abstract
INTRODUCTION
Trabecular Titanium is an open-cell regular structure composed by hexagonal cells of controlled pore, manufactured by Electron Beam Melting (EBM) technology, that allows moulding of cellular solid structures. The Lima Delta TT revision cups are One and Revision, which is characterized by a caudal hook and fins. Both allow internal modularity and cranial TT augments.
The aim of this prospective study is to evaluate the short to medium-term clinical and radiographic outcomes of acetabular revision cups in TT.
METHODS
Between December 2008 and March 2013 we performed 60 cup revisions, 33 with the Revision cup and 27 with the One cup.
The bone defect was classified according to Paprosky acetabular classification: type IIb and IIc presenting continent anterior and posterior acetabular wall were treated by Delta One TT; type IIIa and IIIb were treated with Delta TT Revision. In 20 cases (3.3%) stem revision was associated. Causes of revision were: aseptic loosening in 48 cases, periprosthetic acetabular fractures in 5 cases, recurrent dislocation in 5 cases, infection in 2 cases. In 52 cases bone grafts were used to fill cavitary defects (AIR 1–4). Hemispheric TT augments were used in 13 cases with the same aim. Internal modules were used in 39 cases to restore correct offset. The mean age of patients was 69.6 years (range 29–90). The average follow-up was 39 months (range 19–70).
RESULTS
Mean Harris Hip Score (HHS) was 39.9 preoperatively and 82.7 at last follow-up. We had no intraoperative complications.
We had 2 cases of superficial infection, one of which required revision of the surgical wound. 4 patients suffered dislocation episodes (1 recurrent); none of them required revision. We had 1 case of asymptomatic aseptic loosening, which did not require intervention. In the remaining cases no radiographic evidence of radiolucent lines was noticed at follow up, neither any evidence of aseptic loosening. The graft was considered to be integrated in all cases.
DISCUSSION AND CONCLUSION
Trabecular Titanium revision cups showed high capacity of osseointegration, providing good results in short to medium-term follow-up. Further studies are necessary to assess long-term survivorship.
