Abstract
Introduction
Trabecular titanium implants are 3D printed with a high-friction ingrowth surface that is continuous with the rest of the acetabular shell. The ability to “face-change” following optimum seating of the component allows unprecedented levels of versatility in acetabular orientation. Bolt-on augments enable rapid trialling and definitive insertion of a monobloc construct. The use of these implants has rapidly increased in the National Joint Registry over the last three years with little published outcome data. We present one of the largest studies using this material.
Objectives
This study assesses the early stability, ingrowth and clinical outcome of revision acetabular reconstruction with trabecular titanium.
Methods
120 consecutive acetabular revisions were prospectively evaluated radiographically and clinically with a 2 to 5 year follow-up
Results
The indications for revision were aseptic loosening (84) infection (20), dislocation/ instability (9), metallosis (6) and impingement (1)
The defects were classified as type I in 2 cases, IIA in 26, IIB in 47, IIC in 15, IIIA in 25 and IIIB in 5.
External augments were used in 16 cases and face changing liners in 40 cases.
Mean preoperative Oxford Hip Score was 24 (range 13–33) with a postoperative mean score of 36 (range 13–46).
No patients were lost to follow-up which was from 2 to 4 years (mean 3 years)
Two cases were subsequently revised for infection and two for instability. One case was revised for material failure as a result of a cross-threaded screw.
There were no cases of aseptic loosening and all remaining implants appear well-integrated radiographically.
Conclusions
These early results are very encouraging with excellent initial stability clinically and radiographically. The versatility of face-changing liners, multiple bearing options and bolt-on augments allows rapid and accurate reconstruction. The data support the use of this material and we will continue to report the outcome of this series.
