Survivorship of a contemporary highly porous titanium hemispherical acetabular cup in primary and revision total hip arthroplasty.

Overview

abstract

BACKGROUND: Cementless acetabular cups are widely used in total hip arthroplasty (THA). Highly porous metal cups were introduced with the goal of enhancing osseointegration and survivorship of these components. The purpose of this study was to investigate survivorship and failure mechanisms of a contemporary highly porous metal cup in primary and revision THA. METHODS: There were 154 patients treated with a highly porous metal (OsseoTi) cup during primary THA (71) or revision THA (83) from 2016 to 2022. Chart review was performed to collect demographic information, surgical information, implant specifics, survivorship, and failures of these components. Descriptive statistics and survival probability were calculated, and a log-rank test was used to identify differences between curves. Radiographic review was performed to evaluate for radiographic evidence of loosening. RESULTS: Mean age was 64.4 ± 14.3 years, 108 (70.1%) were women, and mean BMI was 28.0 ± 6.3 kg/m². Mean clinical follow-up was 37.8 ± 18.3 months. Liner types included 106 dual mobility (68.8%), 28 high wall (18.2%), and 20 neutral (13.0%). Overall survivorship free from acetabular revision at 4 years was 88.2% (CI 45.2-98.0%). Acetabular survivorship at 4 years was 100% in primary THA versus 79.0% (CI 44.3-100%) in revision THA (p = 0.21). There were 2 failures (1.3%) for aseptic loosening that occurred at 2- and 41-months following revision THA. Radiographic review of one year postoperative radiographs demonstrated possible acetabular component loosening in 1 primary THA patient (2.2%) and 2 revision THA patients (3.8%). CONCLUSION: We reported good 4-year survivorship of a highly porous metal cup after primary and revision THA, with two failures for aseptic loosening. This survivorship was supported by low rates of radiographic evidence of loosening. Future studies are encouraged to investigate outcomes and survivorship of highly porous shells with follow up at longer intervals.