Mid-Term Outcomes of a Next-Generation Modular Acetabular System in Primary and Revision Total Hip Arthroplasty

Background/Objectives: Total hip arthroplasty (THA) is a common orthopedic procedure, and with projected growth in both primary and revision surgical volumes, robust implant performance data is necessary to inform surgical decision-making. To ensure successful outcomes in primary THA (pTHA) and revision THA (rTHA), surgeons need versatile implant systems that can address patient-specific surgical challenges. This study aimed to evaluate the outcomes of a next-generation acetabular system used for various indications in both pTHA and rTHA. Methods: We retrospectively reviewed 319 patients who underwent either pTHA or rTHA using a modern acetabular system at a single urban academic center between 2014 and 2023 with at least 18 months of follow-up. Baseline characteristics and the patient-reported Hip Disability and Osteoarthritis Outcome Score, Joint Replacement (HOOS, JR) were collected. A total of 284 patients who underwent pTHA and 35 patients who underwent rTHA were included. Median follow-up was 2.6 years (range: 1.5-8.4 years). Results: The most common indication was osteoarthritis (90%) for pTHA and instability (46%) for rTHA. Most rTHAs utilized a dual-mobility construct (74%), compared to pTHAs (22%). There were ten all-cause acetabular revisions in the entire cohort (eight in pTHA, two in rTHA), four of which were aseptic (three in pTHA, one in rTHA). All-cause and aseptic acetabular survivorship of the pTHA cohort was 97.2% and 98.7%, respectively, and of the rTHA cohort was 94.3% and 97.1%, respectively. Improvement in the median HOOS, JR score was 21.5 points at one year and 25.5 points at two years among pTHAs. Conclusions: The findings with this system support adequate mid-term acetabular component survivorship in pTHA and rTHA, along with clinically meaningful functional improvement following pTHA. Given the retrospective, observational nature of this study, further prospective research with extended follow-up and larger sample sizes, particularly in the rTHA cohort, is needed to better assess long-term outcomes.