Outcomes of novel 3D-printed fully porous titanium cup and a cemented highly cross-linked polyethylene liner in complex and revision total hip arthroplasty

Authors

Ittai Shichman, Department of Orthopedic Surgery, NYU Langone Health, New York, NY, 10010, USA.
Lyndsay Somerville, Adult Hip and Knee Reconstructive Surgery, London Health Sciences Centre - University Hospital, London, ON, N6A 5A5, Canada.
William B. Lutes, Advocate Aurora Health
Stephen A. Jones, Department of Trauma and Orthopaedics, University Hospital of Wales and University Hospital, Llandough, CF64 2XX, Wales, UK.
Richard McCalden, Department of Orthopaedic Surgery, London Health Sciences Centre, Western University, London, ON, N6A 5A5, Canada.
Ran Schwarzkopf, Department of Orthopedic Surgery, NYU Langone Health, New York, NY, 10010, USA. Ran.Schwarzkopf@nyulangone.org.

Recommended Citation

Shichman I, Somerville L, Lutes WB, Jones SA, McCalden R, Schwarzkopf R. Outcomes of novel 3D-printed fully porous titanium cup and a cemented highly cross-linked polyethylene liner in complex and revision total hip arthroplasty. Arthroplasty. 2022;4(1):51. Published 2022 Dec 2. doi:10.1186/s42836-022-00152-5

Affiliations

Aurora Medical Center, Kenosha

Abstract

Introduction: A novel fully porous acetabular titanium shell has been designed to reduce stiffness mismatch between bone and implant and promote osseointegration in complex (cTHA) and revision total hip arthroplasty (rTHA). A highly cross-linked polyethylene (XLPE) liner is cemented within the cup to reduce wear rates and increase survivorship. This study reported the outcomes of an XLPE liner cemented into a novel 3D-printed fully porous cup in cTHA and rTHA.

Methods: Presented was a multicenter retrospective review of 40 patients (6 cTHA and 34 rTHA) who underwent THA with a fully porous titanium acetabular cup and cemented XLPE liner. Data were collected on demographics, surgical information, outcomes, including osseointegration and migration and implant survivorship.

Results: On average, patients were 71.42 ± 9.97 years old and obese (BMI: 30.36 ± 6.88 kg/m²) and were followed up for a mean time of 2.21 ± 0.77 years. Six patients underwent cTHA and 34 patients underwent rTHA. The mean hospital length of stay was 5.34 ± 3.34 days. Three (7.5%) 90-day readmissions were noted. Harris Hip Scores improved, on average, from 53.87 ± 12.58 preoperatively to 83.53 ± 12.15 postoperatively (P<0.001). One case of acetabular shell aspetic loosening with migration was noted. Thirty-nine of the 40 acetabular components were fully osseointegrated without migration. Two patients underwent re-revision surgery for PJI and one patient received acetabular shell+liner re-revision due to aseptic loosening. Kaplan-Meier analysis showed an all-cause revision-free survival rate of 95.0% at 6 months and 1 year, and 92.0% at 4-years. Aseptic acetabular cup, liner dislocation/loosening, and fracture-free survival was 100% at 6 months and 1-year, and 97.1% at 2 years.

Conclusion: The combined use of a novel 3D-printed fully porous titanium acetabular shell and cemented XLPE acetabular liner yielded excellent rates of osseointegration, and all-cause and acetabular aseptic loosening survivorship at a minimum 1-year follow-up. Further long-term studies are needed to assess the longevity of this construct.

Document Type

Article

PubMed ID

36457035