Trabecular metal acetabular components in primary total hip arthroplasty

Area of Science:

• Orthopedic Surgery
• Biomaterials Science
• Arthroplasty Research

Background:

• Trabecular metal (TM) cups are increasingly used in primary total hip arthroplasty (THA).
• Existing evidence suggests TM cups may reduce periprosthetic infection (PPI) rates.
• This study investigates TM cup survivorship and PPI risk in primary THA.

Purpose of the Study:

• To compare the survivorship of TM cups versus other uncemented cups in primary THA.
• To evaluate if TM cups are associated with a reduced risk of periprosthetic infection (PPI).

Main Methods:

• Analysis of 10,113 primary THAs with TM cups and 85,596 with other uncemented cups.
• Data sourced from two high-quality national arthroplasty registries.
• Mean follow-up: 3.0 years for TM cups, 3.8 years for others; Cox regression analysis.

Main Results:

• Overall 8-year survivorship was lower for TM cups (94.4%) than other uncemented cups (96.2%) (p < 0.001).
• TM cups showed a persistently higher revision risk (HR=1.5, p < 0.001) after adjusting for covariates.
• Revision rate for PPI was slightly higher, though not statistically significant, in the TM group (1.2%).

Conclusions:

• Primary THA with TM cups has a higher risk of revision for any reason compared to other uncemented cups.
• No evidence supports a lower revision rate for PPI with TM cups in primary THA.
• Caution is advised regarding the increasing use of TM cups in uncomplicated primary THAs.