Promising early results for trabecular metal acetabular components used at revision total hip arthroplasty: 42 acetabular revisions followed with radiostereometry in a prospective randomised trial

Bone Joint J. 2017 Jul;99-B(7):880-886. doi: 10.1302/0301-620X.99B7.BJJ-2016-1241.R1.

Abstract

Aims: The aim of this study was to compare the incidence of aseptic loosening after the use of a cemented acetabular component and a Trabecular Metal (TM) acetabular component (Zimmer Inc., Warsaw, Indiana) at acetabular revision with bone impaction grafting.

Patients and methods: A total of 42 patients were included in the study. Patients were randomised to receive an all- polyethylene cemented acetabular component (n = 19) or a TM component (n = 23). Radiostereometric analysis and conventional radiographic examinations were performed regularly up to two years post-operatively or until further revision.

Results: The proximal migration was significantly higher in the cemented group. At two years, the median proximal migration was 1.45 mm and 0.25 mm in the cemented and TM groups, respectively (p = 0.02). One cemented component was revised due to dislocation. There were no revisions in the TM group.

Conclusion: Lower proximal migration in the TM group suggests that this design might be associated with a lower risk of aseptic loosening in the long term compared with an all polyethylene cemented component. Longer follow-up is required to confirm the clinical advantages of using this component at acetabular revision. Cite this article: Bone Joint J 2017;99-B:880-6.

Keywords: Radiostereometric analysis; Revision hip arthroplasty; Trabecular metal.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Acetabulum
  • Adult
  • Aged
  • Arthroplasty, Replacement, Hip / instrumentation*
  • Bone Transplantation
  • Female
  • Hip Prosthesis*
  • Humans
  • Male
  • Metals
  • Middle Aged
  • Polyethylene
  • Prospective Studies
  • Prosthesis Design
  • Prosthesis Failure
  • Radiostereometric Analysis
  • Reoperation
  • Treatment Outcome

Substances

  • Metals
  • Polyethylene