Additive manufacturing (3D printing) is used to create porous surfaces that promote bone ingrowth in an effort to improve initial stability and optimize long-term biological fixation. The acetabular cup that was studied is manufactured with titanium alloy powder via electron beam melting. Electron beam melting integrates the porous and solid substrate rather than sintering a porous coating to a solid surface. The 3D-printed acetabular cup's high surface coefficient of friction (up to 1.2), combined with its geometry, creates a predictable press-fit in the acetabulum, improving initial mechanical stability and ultimately leading to reproducible biologic fixation. The objective of this study was to evaluate the early clinical outcomes and implant fixation of this 3D-printed acetabular cup in total hip arthroplasty (THA). Four hundred twenty-eight subjects from 8 US and international research sites underwent primary THA with the 3D-printed acetabular cup. All sites received IRB approval prior to conducting the study, and all participants signed the informed consent. Screw usage and number used during surgery were used as a surrogate measurement for initial implant fixation. Clinical performance outcomes included pre- and post-operative Harris Hip Scores (HHS) and Oxford Hip Scores (OHS), patient satisfaction, and revision assessment. 215 patients had a minimum 1-year post-operative follow-up visit. Student t-tests were used to identify significant mean differences (p<0.05).INTRODUCTION
METHODS
A better understanding of the rate of improvement associated with aTSA and rTSA is critical to establish accurate patient expectations for treatment to reduce pain and restore function; more realistic patient expectations pre-operatively may lead to greater patient satisfaction post-operatively. To this end, this study quantifies the rate of improvement in outcomes of aTSA and rTSA using 5 different scoring metrics for 1641 patients with one platform shoulder arthroplasty system. 1641 patients (mean age: 69.3yrs) were treated by 14 orthopaedic surgeons using one platform shoulder system (Exactech, Inc). 729 patients received aTSA (65.3yrs; 384F/345M) for treatment of degenerative arthritis and 912 patients received rTSA (72.5yrs; 593F/319M) for treatment of CTA/RCT/OA. Each patient was scored pre-operatively and at various follow-up intervals (3 months, 6months, annually, etc) using the SST, UCLA, ASES, Constant, and SPADI metrics; active abduction, active forward flexion, and active/passive external rotation were also measured. 4439 total follow-up reports were analyzed (1851 and 2588 rTSA). Improvements in outcome using each metric score were calculated and normalized on a 100 point scale. The rate of improvement was analyzed using a 40 point moving filter treadline and with a 3rd order polynomial treadline over the entire range of follow-up.Introduction
Methods