Highly Porous Tantalum Acetabular Components Without Ancillary Screws Are Non-inferior at 7 Years When Compared With Titanium Components With Ancillary Screw Fixation: A Randomized Controlled Trial

IF 1.5 Q3 ORTHOPEDICS

Arthroplasty Today Pub Date : 2025-05-17 DOI:10.1016/j.artd.2025.101709

Thomas S. Robertson MBBS , Lucian B. Solomon MD, PhD, FRACS , Donald W. Howie MBBS, PhD, FRACS , Oksana T. Holubowycz PhD , Chan Hee Cho BHMS Hons , Stuart A. Callary BAppSc, PhD

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引用次数: 0

Abstract

Background

While porous tantalum components have shown to be advantageous in the revision setting, registry studies have identified tantalum components used in primary total hip arthroplasty (THA) to be associated with an increased risk of revision. The only study to examine the migration of tantalum acetabular components with radiostereometric analysis (RSA) beyond 2 years found continued migration. The aim of this 7-year follow-up RSA study was to determine if the mid-term migration of tantalum acetabular components without ancillary screw fixation is no greater than that of fiber metal titanium components with one ancillary screw fixation.

Methods

We prospectively reviewed the mid-term implant stability of patients who underwent primary THA and were randomized intra-operatively to receive either the tantalum or titanium acetabular component. Of the initial 66 patients enrolled, 51 (77.3%) were available at 7-year follow-up; 2 tantalum components were revised due to recurrent dislocation and infection, respectively, and 2 titanium components underwent open reduction internal fixation to treat femoral periprosthetic fracture. Acetabular component migration relative to the surrounding acetabular bone was measured using RSA at 4-6 days post-operatively and at 6 weeks, 3 months, 1, 2, 3, 5, and 7 years following THA.

Results

At 7 years, the mean proximal migration of tantalum components was 0.22 mm (95% confidence interval 0.08-0.35) and non-inferior to that of titanium components at 0.19 mm (95% confidence interval 0.07-0.32). In addition, the mean proximal migration of tantalum components was non-inferior to that of titanium at both 3 and 5 years. There were no significant differences noted between cohorts for any other axis of translation and rotation.

Conclusions

The continued mid-term stability of tantalum acetabular components without ancillary screw fixation is encouraging for long-term stability. The non-inferiority compared to titanium acetabular components with established excellent long-term survivorship provides reassurance to the operative surgeon using tantalum components in the primary setting.

Level of Evidence

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无辅助螺钉的高多孔钽髋臼假体与有辅助螺钉固定的钛假体相比，在7年后的疗效不差：一项随机对照试验

背景：虽然多孔钽材料在翻修中具有优势，但注册研究发现，在初次全髋关节置换术（THA）中使用钽材料会增加翻修的风险。唯一一项用放射立体分析（RSA）检查2年以上钽髋臼成分迁移的研究发现持续迁移。这项为期7年的RSA随访研究的目的是确定没有辅助螺钉固定的钽髋臼假体的中期迁移是否不大于有辅助螺钉固定的金属纤维钛假体。方法我们前瞻性地回顾了首次行THA患者的中期植入物稳定性，并在术中随机分配接受钽或钛髋臼假体。在最初入组的66例患者中，51例（77.3%）在7年随访中可用；2例钽假体分别因复发脱位和感染进行了修正，2例钛假体行切开复位内固定治疗股骨假体周围骨折。在THA术后4-6天以及THA术后6周、3个月、1、2、3、5和7年使用RSA测量髋臼假体相对于周围髋臼骨的移动。结果7年期间，钽组件的平均近端偏移量为0.22 mm(95%可信区间0.08 ~ 0.35)，不低于钛组件的0.19 mm（95%可信区间0.07 ~ 0.32）。此外，在3岁和5岁时，钽成分的平均近端迁移不低于钛成分。任何其他平移和旋转轴在队列之间没有显著差异。结论钽髋臼假体在无辅助螺钉固定的情况下保持中期稳定性，有利于长期稳定。与钛髋臼假体相比，钛髋臼假体具有良好的长期生存期，这为在初始环境中使用钽假体的外科医生提供了保证。证据水平。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Arthroplasty Today Medicine-Surgery

CiteScore

2.90

自引率

0.00%

发文量

258

审稿时长

40 weeks

期刊介绍： Arthroplasty Today is a companion journal to the Journal of Arthroplasty. The journal Arthroplasty Today brings together the clinical and scientific foundations for joint replacement of the hip and knee in an open-access, online format. Arthroplasty Today solicits manuscripts of the highest quality from all areas of scientific endeavor that relate to joint replacement or the treatment of its complications, including those dealing with patient outcomes, economic and policy issues, prosthetic design, biomechanics, biomaterials, and biologic response to arthroplasty. The journal focuses on case reports. It is the purpose of Arthroplasty Today to present material to practicing orthopaedic surgeons that will keep them abreast of developments in the field, prove useful in the care of patients, and aid in understanding the scientific foundation of this subspecialty area of joint replacement. The international members of the Editorial Board provide a worldwide perspective for the journal''s area of interest. Their participation ensures that each issue of Arthroplasty Today provides the reader with timely, peer-reviewed articles of the highest quality.