Department of Orthopaedic Surgery, Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, Pennsylvania.
Clinical Research Department, Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, Pennsylvania.
Surg Technol Int. 2021 May 20;38:393-398. doi: 10.52198/21.STI.38.OS1398.
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).
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.
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%).
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.
增材制造技术越来越多地被应用，不仅可以制造出具有与松质骨复杂小梁结构非常相似的多孔涂层结构的髋臼部件，而且还可以一步制造出整个植入物。本研究旨在评估一种新的增材制造髋臼杯在初次全髋关节置换术（THA）中的两年临床和影像学结果。
我们回顾了 2016 年 12 月至 2018 年 12 月期间在我们机构进行的 266 例初次 THA（254 例患者），使用通过增材制造制造的新型高多孔钛髋臼壳。使用 SF/VR-12 和 HOOS JR 测量临床和功能结果，以确定患者对手术的满意度。评估 X 线片以确定有无迁移、透亮线和松动。审查患者记录以评估髋臼杯在所有原因翻修和无菌性髋臼杯松动翻修方面的存活率。
在至少两年的随访（范围：2-3.45 年）中，患者队列在术后功能评分（髋关节残疾和关节置换骨关节炎结果评分 [HOOS JR.] 和临床评分（12 项简短健康调查 [SF/VR-12]）方面均有显著改善（p<0.001）。一个髋臼杯在假体-骨界面处出现进行性透亮线，提示松动，并进行了翻修。无任何原因失败的髋臼组件两年存活率为 97.4%（95%置信区间 [CI]：95.5-99.4%）。当以髋臼组件的无菌性松动为失效终点时，两年存活率为 99.6%（95% CI：98.9-100%）。
通过增材制造制造的高多孔钛非骨水泥髋臼杯在初次 THA 中显示出有前途的早期临床和影像学结果，其无菌性松动率较低。需要进一步的随访研究来评估这种新型髋臼组件的长期存活率和结果。
