Mid- to long-term follow-up of trabecular titanium acetabular cups in hip revision surgery for acetabular bone defects.

BACKGROUND: Acetabular defects can be restored using different surgical techniques. Excellent results have been observed with trabecular titanium (TT) which mimic the structure of trabecular bone. The aim of our study is to evaluate the mid-to-long-term outcome in revision surgery due to severe acetabular defect using TT cups.

MATERIALS AND METHODS: We performed a retrospective analysis of patients undergoing revision with Paprosky IIa or higher using modular TT cup. We evaluated clinical outcomes using FJS, WOMAC, OHS, and WORQ. Radiolucency and integration were used to assess radiographic results. We collected information on complications and revisions.

RESULTS: Data from 217 consecutive patients was collected. Mean age was 71,01 ± 11,40 years. In regard to diagnosis, patients were affected by: aseptic loosening (55,3%); debris-induced osteolysis (18%); infection (11,5%); PPF (7.8%); and dislocation (7.4%). At the final floow-up, we documented the following: OHS 35.06 ± 4,31; WORQ 26.69 ± 4.18; WOMAC 27.59 ± 7.57; FJS of 55.3 ± 10.39 (p-value < 0.005). Complication rate was 9.2%. The most frequent complication was dislocation, followed by deep infection and aseptic loosening. The Kaplan-Meier survivorship curve showed a 96.3% rate of acetabular implant survival at 12 years.

DISCUSSION AND CONCLUSIONS: This is the study with the largest population using TT for acetabular defects. We report good outcomes and an acceptable rate of complications, also due to implant modularity allowing stable fixation with secondary osseointegration.