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Highly Porous Titanium Cups versus Hydroxyapatite-Coated Sockets: Mid-Term Results in Metachronous Bilateral Total Hip Arthroplasty

Highly Porous Titanium Cups versus Hydroxyapatite-Coated Sockets: Mid-Term Results in Metachronous Bilateral Total Hip Arthroplasty

Medical Principles and Practice 2019

Highly porous titanium cups have been recently introduced, with contradictive outcomes. A retrospective consecutive case series involving bilateral metachronous total hip arthoplasties (THAs) performed with two different cups, Fixa (F) and Fixa Tipor (T) (Adler Ortho, Milan), and the same stem, was evaluated. T sockets, manufactured using electron beam melting, were supposed to prove superior in terms of clinical results, survival rates and radiographic parameters in comparison to hydroxyapatite coated F cups with conventional porosity. 24 bilateral metachronous THAs with F cup on one side and T socket on the other side were evaluated. Pre-operative and post-operative Harris Hip Score (HHS) was collected for every patient. Radiographic signs of loosening were assessed. The radiographic signs of osseointegration (radiolucent lines, superolateral buttress, inferomedial buttress, radial trabeculae and stress shielding) were evaluated. No intraoperative complications occurred. The mean HHS score was excellent and comparable in both groups. At the mean follow-up of 134 months (F) and 79 months (T), no cup or liner revisions were performed. No radiographic signs of loosening were reported. All the patients revealed 3 parameters of good bony ingrowth at least. Both groups showed similar radiographic parameters regarding osseointegration, which were stable over the time. Stress shielding was more evident in T cohort (p = 0.07). Highly porous titanium cups produced using an additive manufacturing and electron beam melting technology achieved reliable mid-term clinical and radiographic results, not inferior to second generation cups.

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Accession: 066775378

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PMID: 31079112

DOI: 10.1159/000500876

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