scholarly journals Radiographic assessment of radiolucent lines around a highly porous titanium cup (Tritanium) using digital tomosynthesis, after total hip arthroplasty

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Kazuki Oishi ◽  
Yuji Yamamoto ◽  
Yoshifumi Harada ◽  
Ryo Inoue ◽  
Eiji Sasaki ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Japanese Orthopaedic Association ◽  
Porous Titanium ◽  
Plain Radiography ◽  
Digital Tomosynthesis ◽  
Related Factors ◽  
Total Hip ◽  
Radiolucent Lines ◽  
Highly Porous

Abstract Background The objectives of this study were to assess radiolucent lines around a highly porous titanium cup (Tritanium) using digital tomosynthesis and to investigate the clinical and radiographic factors associated with radiolucent lines on tomosynthesis. Methods Fifty-five patients underwent total hip arthroplasty using a Tritanium cup, and digital tomosynthesis and plain radiography were performed at 1 week, 6 months, 1 year, and 2 years after surgery. The radiolucent lines around the cup were measured on both DTS and plain radiography at each postoperative period. Clinical evaluations were performed by the Japanese Orthopaedic Association hip disease evaluation questionnaire (JHEQ), and revision surgeries were examined. Based on the presence of radiolucent lines on digital tomosynthesis at 2 years postoperatively, patients were divided into RL (+) and RL (−) groups and investigated for related factors. Results There were 20 cases in the RL (+) group and 35 cases in the RL (−) group, and no revision surgeries were required. Statistically, there were more cases with radiolucent lines on digital tomosynthesis (45.4% at 1 week and 36.3% at 2 years) than on plain radiography (9.1% at 1 week and 9.1% at 2 years) at each postoperative point. Logistic analysis showed no significant associations between the presence of radiolucent lines at 2 years on digital tomosynthesis, and the JHEQ parameters of pain (p = 0.937), movement (p = 0.266), or mental status (p = 0.404). Conclusion In a short-term evaluation up to 2 years, digital tomosynthesis detected more radiolucent lines around the titanium cups than plain radiography. The occurrence of radiolucent lines was not related to the postoperative clinical evaluation.

Highly porous titanium cup in cementless total hip arthroplasty: registry results at eight years

2018 ◽  
Vol 43 (8) ◽  
pp. 1815-1821 ◽  
Author(s):  
Francesco Castagnini ◽  
Barbara Bordini ◽  
Susanna Stea ◽  
Pierina Paola Calderoni ◽  
Claudio Masetti ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Porous Titanium ◽  
Total Hip ◽  
Cementless Total Hip Arthroplasty ◽  
Arthroplasty Registry ◽  
Highly Porous

scholarly journals Mid-Term Results of Total Hip Arthroplasty Using A Three-Dimensional Porous Titanium Acetabular Cup: An Examination of Micromotion Using Subject-Specific Finite Element Analysis

2021 ◽  
Author(s):  
Takaki Miyagawa ◽  
Kazu Matsumoto ◽  
Shingo Komura ◽  
Haruhiko Akiyama
Keyword(s):  
Finite Element ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Three Dimensional ◽  
Porous Titanium ◽  
Fe Analysis ◽  
Total Hip ◽  
Radiolucent Lines ◽  
Subject Specific

Abstract Background: We investigated the mid-term clinical and radiological results of total hip arthroplasty (THA) using a three-dimensional (3D) porous titanium cup and analysed the micromotion at the interface of the cup using subject-specific finite element (FE) analysis. Methods: We evaluated 73 hips of 65 patients (6 men and 59 women; mean age at the time of surgery 62.2 years, range 45-86 years) who had undergone THA using a 3D porous titanium cup. Clinical evaluation was performed using the Japanese Orthopaedic Association (JOA) hip score system. We assessed the fixation of the acetabular component based on the presence of radiolucent lines and cup migration using anteroposterior radiographs. Subject-specific FE models were constructed from computed tomography data. Results: The JOA score improved from a preoperative mean of 52.2 (range, 23-82) to a mean of 87.8 (range, 71-100) at the final follow-up. None of the patients underwent revisions during the follow-up period. Radiolucent lines were observed in 26 cases (35.6%) and frequently appeared at DeLee and Charnley Zone 3. In the FE analysis, the micromotion at DeLee and Charnley Zone 3 was significantly larger than that at Zones 1 and 2. Furthermore, micromotion was large in the groups in which radiolucent lines appeared at Zone 3. Conclusions: The mid-term clinical outcome of THA using a 3D porous titanium cup was excellent. However, radiolucent lines frequently appeared at DeLee and Charnley Zone 3. FE analysis indicated that micromotion was large at the same site, strongly suggesting that it contributes to the emergence of radiolucent lines. The 3D porous titanium cups are useful in THA, and with improvements focused on micromotion, we anticipate better long-term outcomes.

scholarly journals Total Hip Arthroplasty Using Proximal Porous Coating Stem with Distal Sleeve: Mid-Term Outcome

2009 ◽  
Vol 17 (1) ◽  
pp. 36-41 ◽  
Author(s):  
M Saito ◽  
KA Takahashi ◽  
M Fujioka ◽  
K Ueshima ◽  
K Sakao ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Japanese Orthopaedic Association ◽  
Stress Shielding ◽  
Porous Coating ◽  
Occupancy Rate ◽  
Term Outcome ◽  
Total Hip ◽  
Radiolucent Lines ◽  
Bone Changes

Purpose. To report mid-term results of total hip arthroplasty (THA) using the Opti-Fix Plus Hip System (Opti-Fix Hip), and to assess the correlations between peri-implant bone changes and the distal medullary occupancy rate. Methods. 11 men (13 hips) and 53 women (58 hips) aged 24 to 87 (mean, 61) years underwent THA using the Opti-Fix Hip, with a modular stem and a distal sleeve, and were followed up for a mean of 6.5 (range, 4.8–9.6) years. Clinical outcomes were evaluated using the Japanese Orthopaedic Association (JOA) hip score. Implant stability, bone changes around the implant, and the occupancy rate of the stem in the medullary space were examined radiologically. Bone changes around the implant were assessed based on the radiological evidence of a pedestal, osteolysis, stress shielding, and radiolucent lines. Results. The mean JOA score increased significantly after surgery and was maintained at the latest follow-up. Around the acetabular and femoral components respectively, 38 and 58 hips had radiolucent lines, whereas one and 54 hips developed osteolysis. A pedestal appeared in 21 hips and grade-III or higher stress shielding in 30 hips. Two hips showed loosening of the acetabular components, but none in the femoral components. Osteolysis around the stem was frequently observed in hips with poor distal medullary occupancy. Conclusion. Clinical and radiological outcomes of the Opti-Fix Hip were favourable. The low incidence of osteolysis in the distal stem suggests that the proximal circumferential porous coating was effective. Minor osteolysis around the proximal stem was frequently observed, indicating early excessive wear of the polyethylene liner. Its high distal medullary occupancy rate could inhibit stem micromotion and aseptic loosening.

scholarly journals Total hip arthroplasty using a three-dimensional porous titanium acetabular cup: an examination of micromotion using subject-specific finite element analysis

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Takaki Miyagawa ◽  
Kazu Matsumoto ◽  
Shingo Komura ◽  
Haruhiko Akiyama
Keyword(s):  
Finite Element ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Three Dimensional ◽  
Porous Titanium ◽  
Fe Analysis ◽  
Total Hip ◽  
Radiolucent Lines ◽  
Subject Specific

Abstract Background We investigated the mid-term clinical and radiological results of total hip arthroplasty (THA) using a three-dimensional (3D) porous titanium cup and analyzed the micromotion at the interface of the cup using subject-specific finite element (FE) analysis. Methods We evaluated 73 hips of 65 patients (6 men and 59 women; mean age at the time of surgery, 62.2 years; range, 45–86 years) who had undergone THA using a 3D porous titanium cup. Clinical evaluations were performed using the Japanese Orthopaedic Association (JOA) hip score system. We assessed the fixation of the acetabular component based on the presence of radiolucent lines and cup migration using anteroposterior radiographs. Subject-specific FE models were constructed from computed tomography data. Results The JOA score improved from a preoperative mean of 52.2 (range, 23–82) to a mean of 87.8 (range, 71–100) at the final follow-up. None of the patients underwent revisions during the follow-up period. Radiolucent lines were observed in 26 cases (35.6%) and frequently appeared at DeLee and Charnley Zone 3. Following the FE analysis, the micromotion at DeLee and Charnley Zone 3 was significantly larger than that at Zone 2. Furthermore, micromotion was large in the groups in which radiolucent lines appeared at Zone 3. Conclusions The mid-term clinical outcome of THA using a 3D porous titanium cup was excellent. However, radiolucent lines frequently appeared at DeLee and Charnley Zone 3. FE analysis indicated that micromotion was large at the same site, strongly suggesting that it contributes to the emergence of radiolucent lines. The 3D porous titanium cups are useful in THA, and with improvements focused on micromotion, we anticipate better long-term outcomes.

Highly Porous Titanium Acetabular Components in Primary and Revision Total Hip Arthroplasty: A Systematic Review

2020 ◽  
Vol 35 (6) ◽  
pp. 1737-1749 ◽  
Author(s):  
Michael-Alexander Malahias ◽  
Lazaros Kostretzis ◽  
Alex Greenberg ◽  
Vasileios S. Nikolaou ◽  
Amit Atrey ◽  
...  
Keyword(s):  
Systematic Review ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Porous Titanium ◽  
Revision Total Hip Arthroplasty ◽  
Total Hip ◽  
Acetabular Components ◽  
Highly Porous

Midterm Outcomes of Revision Total Hip Arthroplasty With the Use of a Multihole Highly-Porous Titanium Shell

2017 ◽  
Vol 32 (9) ◽  
pp. 2806-2809 ◽  
Author(s):  
Ronald E. Delanois ◽  
Chukwuweike U. Gwam ◽  
Nequesha Mohamed ◽  
Anton Khlopas ◽  
Morad Chughtai ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Porous Titanium ◽  
Revision Total Hip Arthroplasty ◽  
Total Hip ◽  
Highly Porous

A New Additive-Manufactured Cementless Highly Porous Titanium Acetabular Cup for Primary Total Hip Arthroplasty—Early Two-Year Follow Up

2021 ◽  
Author(s):  
Mohammad Abdelaal ◽  
Ilan Small ◽  
Camilo Restrepo ◽  
William Hozack
Keyword(s):  
Additive Manufacturing ◽  
Total Hip Arthroplasty ◽  
Aseptic Loosening ◽  
Acetabular Component ◽  
Hip Arthroplasty ◽  
Porous Titanium ◽  
Total Hip ◽  
Highly Porous ◽  
Primary Total Hip Arthroplasty

Introduction: Additive-manufacturing technologies are increasingly being used, not only to create acetabular components with porous coating architecture very similar to the complex trabecular structure of cancellous bone, but also for producing the entire implant in a single step. The aim of this study is to assess two-year clinical and radiological outcomes of a new additive-manufactured cup in primary total hip arthroplasty (THA). Materials and Methods: We reviewed 266 primary THAs (254 patients) performed in our institution between December 2016 and December 2018 using a new highly porous titanium acetabulum shell fabricated via additive manufacturing. Clinical and functional outcomes were measured using SF/VR-12 and HOOS JR to determine patient satisfaction with surgery. Radiographs were assessed to determine the presence of migration, radiolucency, and loosening. Patients records were reviewed to assess cup survivorship in terms of all-cause revisions and revision for aseptic cup loosening. Results: At a minimum of two-year follow up (range: 2–3.45 years), the patient cohort demonstrated significant improvement in postoperative functional scores (hip disability and osteoarthritis outcome score for joint replacement [HOOS JR.] and clinical scores (12-item short-form health survey [SF/VR-12]) (p<0.001). One cup developed progressive radiolucent lines at the prosthesis-bone interface consistent with loosening and was revised. The overall acetabular component two-year survivorship free of all-cause failure was 97.4% (95% confidence interval [CI]: 95.5–99.4%). When aseptic loosening of the acetabular component was used as the failure endpoint, the two-years survivorship rate was 99.6% (95% CI: 98.9–100%). Conclusion: Highly porous titanium cementless acetabular cups produced via additive-manufacturing showed promising early clinical and radiological results in primary THA with low rates of aseptic loosening. Further follow-up studies are needed to assess the long-term survivorship and outcomes of this new acetabular component.

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