The Journal of Hip Surgery 2019; 03(01): 048-052
DOI: 10.1055/s-0039-1678745
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Cementless Primary Total Hip Arthroplasty with a Trabecular Titanium Implant: Results at Short-to-Medium-Term Follow-Up

Andrea Bertagnon
1  Department of Orthopaedic and Traumatology, IRCCS Istituto Ortopedico Galeazzi, Milano, Italy
Luca Celotti
2  School of Medicine, Università degli Studi dell'Insubria, Varese, Lombardia, Italy
Fabio D'Angelo
3  Division of Orthopedics and Traumatology, Azienda Socio Sanitarie Territoriale dei Sette Laghi, Varese, Lombardia, Italy
Steven Harwin
4  Leni & Peter W. May Department of Orthopedic Surgery, Icahn School of Medicine at Mount Sinai, New York, New York
Ettore Vulcano
4  Leni & Peter W. May Department of Orthopedic Surgery, Icahn School of Medicine at Mount Sinai, New York, New York
Michele Francesco Surace
5  DBSV - Department of Biotechnology and Life Sciences, Università degli Studi dell'Insubria, Varese, Italy
› Author Affiliations
Further Information

Publication History

26 April 2018

06 November 2018

Publication Date:
01 March 2019 (online)


Over the last two decades, cementless hip prostheses gained increasing popularity. Highly porous, trabecular coatings and their promising bone-friendly properties also came to a wider diffusion. As a consequence, this study was aimed to evaluate clinical and radiographic results at short-to-medium term of cementless prosthetic implants with trabecular titanium cup and titanium femoral metaphyseal stem highly porous coatings. From September 2012 to June 2015 213, cementless total hip arthroplasties were performed in 200 patients. All patients received a cementless Accolade II stem and Tritanium cup with UHMWPE Trident X3 Bearing Technology polyethylene liner. All surgeries were performed using a tissue-sparing modified posterolateral approach. All patients underwent prophylaxis for heterotopic ossifications. For every patient, the following data were collected: age, gender, height, weight, body mass index, blood loss, preoperative and postoperative hemoglobin, surgical time, and complications. Harris Hip Score was obtained for every patient. Radiographic measurements were performed using a freeware software (TraumaCAD 2.0). The computed parameters were inclination and anteversion of acetabular cup and presence of heterotopic ossification. The mean follow-up was 37.7 months from surgery. Data were analyzed by SPSS software v 24.0. The postoperative average Harris Hip Score was 87.4 points (range, 40.5–95.7) and 91 patients scored excellent results, with more than 90 points (52.4%). Heterotopic ossifications were seen in 12 patients (6.9%) and correlated to patient weight, surgical timing, and hemoglobin values. There were three cases of dislocation (1.7%) that significantly correlated with cup inclination (R 2 = 17.9; p = 0.018). One cup underwent early revision because of undersizing of the component and subsequent lack of integration, thus leading to an overall survivorship of 99.4%. In conclusion, excellent medium-term functional outcome, patient satisfaction, and low complications rate were observed for the studied implant. A higher incidence of heterotopic ossifications was significantly correlated to patient weight, surgical time, blood loss, and transfusions. Also, inclination of the acetabular cup proved to be correlated to hip dislocation.