Department of Orthopedics, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto, Tokushima, 770-8503, Japan.
Department of Orthopedics, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto, Tokushima, 770-8503, Japan.
J Orthop Sci. 2022 Jan;27(1):163-168. doi: 10.1016/j.jos.2020.11.004. Epub 2020 Dec 17.
A highly porous titanium cup has a unique structure that mimics human trabecular bone and is expected to achieve better outcomes due to rigid fixation and extensive bone ingrowth. Several manufacturers have developed a highly porous titanium cup; however, some have shown a high incidence of radiolucent lines (RLLs) on early postoperative radiographs. In this study, we compared the clinical and radiological outcomes of total hip arthroplasty (THA) using a highly porous titanium cup (OsseoTi, Zimmer Biomet) with those after THA using a conventional hydroxyapatite-coated titanium cup (Trident HA, Stryker).
A total of 201 hips that underwent THA using an OsseoTi cup (n = 101) or Trident cup (n = 100) were enrolled in the study. Patient characteristics, cup alignment, clinical outcome (determined by the Japanese Orthopedic Association [JOA] score), and incidence of RLLs around the cup were evaluated at 3, 6, 12, and 24 months postoperatively.
The clinical outcome was excellent in both groups. The incidence of RLLs was 12.9% at 3 months, 20.8% at 6 months, 23.8% at 12 months, and 22.8% at 24 months after surgery in the OsseoTi group; there were no cases of RLL at any time after surgery in the Trident group. The RLLs were mainly distributed in zone 2. Despite the high rate of RLL in the OsseoTi group, the RLL were narrow and only 5% had a width of >1 mm at 24 months postoperatively. There were no cases with RLLs in all three zones.
Despite excellent clinical outcomes in both study groups, the incidence of RLLs was higher in the OsseoTi group than in the Trident group. Although none of our cases with RLL have required revision surgery for aseptic loosening so far, these patients require careful follow-up.
高度多孔钛杯具有独特的结构,模仿人类小梁骨,预计由于刚性固定和广泛的骨长入,会取得更好的效果。有几个制造商已经开发出了高度多孔钛杯;然而,一些产品在术后早期的 X 光片上显示出较高的透光线(RLL)发生率。在这项研究中,我们比较了使用高度多孔钛杯(OsseoTi,Zimmer Biomet)和传统羟基磷灰石涂层钛杯(Trident HA,Stryker)进行全髋关节置换术(THA)的临床和影像学结果。
共纳入 201 例接受 OsseoTi 杯(n=101)或 Trident 杯(n=100)THA 的患者。在术后 3、6、12 和 24 个月评估患者特征、杯的位置、临床结果(由日本矫形协会[JOA]评分确定)和杯周围 RLL 的发生率。
两组的临床结果均为优秀。在 OsseoTi 组中,术后 3 个月 RLL 的发生率为 12.9%,6 个月为 20.8%,12 个月为 23.8%,24 个月为 22.8%;在 Trident 组中,术后任何时间均无 RLL 发生。RLL 主要分布在 2 区。尽管 OsseoTi 组的 RLL 发生率较高,但 RLL 较窄,术后 24 个月时只有 5%的 RLL 宽度>1mm。在所有三个区域均未发现 RLL 病例。
尽管两组的临床结果均良好,但 OsseoTi 组的 RLL 发生率高于 Trident 组。尽管到目前为止,我们的 RLL 病例均无需进行无菌性松动的翻修手术,但这些患者仍需要密切随访。