Single trabecular titanium Cup-Cage for acetabular bone defects during revision hip arthroplasty: Mid-term outcomes

Area of Science:

• Orthopedic Surgery
• Biomaterials Engineering
• Arthroplasty Research

Background:

• Severe acetabular bone loss presents a significant challenge in revision total hip arthroplasty (rTHA).
• Traditional cup-cage techniques have limitations including technical complexity and variable long-term outcomes.
• The Delta TT system, a novel trabecular titanium construct, aims to enhance stability through biological fixation and mechanical reliability.

Purpose of the Study:

• To evaluate the mid-term clinical and radiographic outcomes of the Delta TT system in complex acetabular reconstructions.
• To assess the efficacy of this cementless cup-cage construct in managing severe bone loss during rTHA.
• To determine the system's potential for promoting osteointegration and functional recovery.

Main Methods:

• A prospective cohort study involving 64 patients (Paprosky type II/III defects) undergoing rTHA with the Delta TT system.
• Functional outcomes assessed using the Merle d'Aubigné and Postel score preoperatively and at a mean 48-month follow-up.
• Radiographic evaluation for implant stability, osteointegration, radiolucency, and complication monitoring.

Main Results:

• Achieved stable radiographic fixation in nearly all cases with evident osteointegration within 12 months.
• Significant improvement in functional outcomes (mean score increase from 8.2 to 15.6, p < 0.001).
• 75% of patients reported good-to-excellent clinical results at mid-term, with a low complication rate and no re-revisions for aseptic loosening.

Conclusions:

• The Delta TT system demonstrates a reliable and biologically favorable approach for severe acetabular defects in rTHA.
• The trabecular titanium structure facilitates durable fixation, radiographic stability, and substantial functional recovery.
• Mid-term findings support the Delta TT system as a valuable option for complex revision hip arthroplasty, though long-term studies are needed.