Conventional Titanium Acetabular Cups vs. Trabecular Titanium Acetabular Cups in Primary Total Hip Arthroplasty: Ten-year Follow-up Clinical and Radiological Results

Document Type : RESEARCH PAPER

Authors

Department of Orthopedic Surgery, La Paz University Hospital, Madrid, Spain

10.22038/abjs.2025.89443.4056

Abstract

Objectives: Evidence supporting the use of trabecular titanium acetabular cups in primary total hip arthroplasty (THA) is generally favorable, especially in the short and mid-term. However, certain considerations remain, and long-term data are still unavailable.
Methods: A total of 53 THAs in 47 patients performed at our institution between 2011 and 2015 were included and divided into two groups to compare clinical and radiological outcomes. Group A included 15 patients with conventional titanium cups, while Group B comprised 38 patients who received trabecular titanium cups.
Results: There were no significant differences between groups regarding demographics, surgical variables, or complication rates. However, patients in Group B were significantly younger and more frequently underwent surgery via a posterolateral approach. Both groups demonstrated significant improvement in Harris Hip Score (HHS) postoperatively (p < 0.05), with Group B showing significantly higher final scores (p < 0.02). Radiographic cup positioning was similar in both groups. Group B exhibited a higher incidence of initial bone–implant gaps in zone 2, which correlated with higher Body Mass Index (p = 0.005) and greater abduction angles (p = 0.03). No osteolysis or component migration was observed. One asymptomatic loosening was noted in Group A. No cup revisions were required in either group during the minimum 10-year follow-up.
Conclusion: Both acetabular cup designs achieved excellent long-term clinical and radiological results. In this cohort, tantalum cups were associated with slightly superior functional outcomes, supporting the hypothesis that higher porosity may promote improved biological integration while maintaining implant stability.
        Level of evidence: II

Keywords

Main Subjects

References

  1. Poursalehian M, Javadzade E, Mortazavia SJ. Recent trends and hotspots in hip arthroplasty: a bibliometric analysis and visualization study of last five-year publications. Arch Bone Jt Surg 2023;11(8):493-501. doi: 10.22038/ABJS.2023.70790.3313.
  2. Boutros M, Nham FH, Corsi MP, et al. Bibliometric analysis of outpatient hip and knee arthroplasty research evolution. Arch Bone Jt Surg 2025;13(2):87-99. doi: 10.22038/ABJS.2024.80590.3681.
  3. Bobyn JD, Stackpool GJ, Hacking SA, Tanzer M, Krygier JJ. Characteristics of bone ingrowth and interface mechanics of a new porous tantalum biomaterial. J Bone Joint Surg Br. 1999;81(5):907-914. doi: 10.1302/0301-620x.81b5.9283.
  4. Macheras G, Kateros K, Kostakos A, Koutsostathis S, Danomaras D, Papagelopoulos PJ. Eight- to ten-year clinical and radiographic outcome of a porous tantalum monoblock acetabular component. J Arthroplasty. 2009;24(5):705-709. doi: 10.1016/j.arth.2008.06.020.
  5. Macheras GA, Lepetsos P, Leonidou AO, Anastasopoulos PP, Galanakos SP, Poultsides LA. Survivorship of a porous tantalum monoblock acetabular component in primary hip arthroplasty with a mean follow-up of 18 years. J Arthroplasty. 2017;32(12):3680-3684. doi: 10.1016/j.arth.2017.06.049.
  6. Kostakos AT, Macheras GA, Frangakis CE, Stafilas KS, Baltas D, Xenakis TA. Migration of the trabecular metal monoblock acetabular cup system. J Arthroplasty. 2010;25(1):35-40. doi: 10.1016/j.arth.2008.09.027.
  7. Mohaddes M, Rolfson O, Kärrholm J. Short-term survival of the trabecular metal cup is similar to that of standard cups used in acetabular revision surgery. Acta Orthop. 2015;86(1):26-31. doi: 10.3109/17453674.2014.984114.
  8. Clement RGE, Ray AG, MacDonald DJ, Wade FA, Burnett R, Moran M. Trabecular metal use in Paprosky type 2 and 3 acetabular defects: 5-year follow-up. J Arthroplasty. 2016;31(4):863-867. doi: 10.1016/j.arth.2015.10.033.
  9. Konan S, Duncan CP, Masri BA, Garbuz DS. Porous tantalum uncemented acetabular components in revision total hip arthroplasty: a minimum ten-year clinical, radiological and quality of life outcome study. Bone Joint J. 2016;98-B(6):767-771. doi: 10.1302/0301-620X.98B6.37183.
  1. Steno B, Kokavec M, Necas L. Acetabular revision arthroplasty using trabecular titanium implants. Int Orthop. 2015;39(3):389-395. doi: 10.1007/s00264-014-2509-5.
  2. Perticarini L, Zanon G, Rossi SM, Benazzo FM. Clinical and radiographic outcomes of a trabecular titanium™ acetabular component in hip arthroplasty: results at minimum 5 years follow-up. BMC Musculoskelet Disord. 2015;16:375. doi: 10.1186/s12891-015-0822-9.
  3. Huang Y, Zhou YX, Tian H, Wang JW, Liu WG, Li H. Minimum 7-year follow-up of a porous coated trabecular titanium cup manufactured with electron beam melting technique in primary total hip arthroplasty. Orthop Surg. 2021;13(3):817-824. doi: 10.1111/os.12846.
  4. Hardinge K. The direct lateral approach to the hip. J Bone Joint Surg Br. 1982;64(1):17-19. doi: 10.1302/0301-620X.64B1.7068713.
  5. Harris WH. Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. An end-result study using a new method of result evaluation. J Bone Joint Surg Am. 1969;51(4):737-755.
  6. Gandek B, Roos EM, Franklin PD, Ware JE Jr. Item selection for 12-item short forms of the Knee injury and Osteoarthritis Outcome Score (KOOS-12) and Hip disability and Osteoarthritis Outcome Score (HOOS-12). Osteoarthritis Cartilage. 2019;27(5):746-753. doi: 10.1016/j.joca.2018.11.011.
  7. Ranawat CS, Dorr LD, Inglis AE. Total hip arthroplasty in protrusio acetabuli of rheumatoid arthritis. J Bone Joint Surg Am. 1980;62(7):1059-1065.
  8. DeLee JG, Charnley J. Radiological demarcation of cemented sockets in total hip replacement. Clin Orthop Relat Res. 1976;121:20-32.
  9. Anil U, Singh V, Schwarzkopf R. Diagnosis and detection of subtle aseptic loosening in total hip arthroplasty. J Arthroplasty. 2022;37(8):1494-1500. doi: 10.1016/j.arth.2022.02.060.
  10. De Martino I, De Santis V, Sculco PK, D'Apolito R, Poultsides LA, Gasparini G. Long-term clinical and radiographic outcomes of porous tantalum monoblock acetabular component in primary hip arthroplasty: a minimum of 15-year follow-up. J Arthroplasty. 2016;31(9 Suppl):110-114. doi: 10.1016/j.arth.2015.12.020.
  11. Wegrzyn J, Kaufman KR, Hanssen AD, Lewallen DG. Performance of porous tantalum vs. titanium cup in total hip arthroplasty: randomized trial with minimum 10-year follow-up. J Arthroplasty. 2015;30(6):1008-1013. doi: 10.1016/j.arth.2015.01.013.
  12. Malahias MA, Kostretzis L, Greenberg A, Nikolaou VS, Atrey A, Sculco PK. Highly porous titanium acetabular components in primary and revision total hip arthroplasty: a systematic review. J Arthroplasty. 2020 ;35(6):1737-1749. doi: 10.1016/j.arth.2020.01.052.
  13. Gruen TA, Poggie RA, Lewallen DG, et al. Radiographic evaluation of a monoblock acetabular component: a multicenter study with 2- to 5-year results. J Arthroplasty. 2005;20(3):369-378. doi: 10.1016/j.arth.2004.12.049.
  14. Stocks GW, Freeman MA, Evans SJ. Acetabular cup migration. Prediction of aseptic loosening. J Bone Joint Surg Br. 1995;77(6):853-861.
  15. Krismer M, Stöckl B, Fischer M, Bauer R, Mayrhofer P, Ogon M. Early migration predicts late aseptic failure of hip sockets. J Bone Joint Surg Br .1996;78(3):422-426.
  16. Sochart DH. Relationship of acetabular wear to osteolysis and loosening in total hip arthroplasty. Clin Orthop Relat Res. 1999;363:135-150.
  17. Müller U, Gautier E, Roeder C, Busato A. The relationship between cup design and the radiological signs of aseptic loosening in total hip arthroplasty. J Bone Joint Surg Br. 2003;85(1):31-36. doi: 10.1302/0301-620x.85b1.12925.
  18. Miller AN, Su EP, Bostrom MP, Nestor BJ, Padgett DE. Incidence of ceramic liner malseating in Trident acetabular shell. Clin Orthop Relat Res. 2009;467(6):1552-1556. doi: 10.1007/s11999-009-0770-5.
  19. Rambani R, Nayak M, Aziz MS, Almeida K. Tantalum versus titanium acetabular cups in primary total hip arthroplasty: current concept and a review of the current literature. Arch Bone Jt Surg. 2022;10(5):385-394. doi: 10.22038/ABJS.2021.55255.2750.

 

 

 

 

 

The Archives of Bone and Joint Surgery
Volume 14, Issue 1
January 2026
Pages 41-48

Files

History

  • Receive Date: 10 July 2025
  • Revise Date: 29 December 2025
  • Accept Date: 04 August 2025

Share

How to cite

Statistics