Abstract
Introduction: Trabecular Metal (Tantalum) has been successfully used in Neurosurgery for many years. Acetabular components have only been available in the UK since 2004. The metal’s properties of porosity and a high friction coefficient are attractive, particularly in complex primary and revision hip arthroplasty when surgical challenges include abnormal, deficient or limited bone.
Methods: Two year results of 110 consecutive acetabular reconstructions are presented. The age range was between 27 and 95 years with a predominance of females. The indication in 75 primary hip replacements included, Destructive Osteoarthritis, Dysplasia, Rheumatoid Arthritis, Paget’s and AVN. 35 revisions were performed either two-component or single acetabular exchanges.
Clinical results have been obtained using the Merle d’Aubigne score and bone deficiencies were classified according to the AAOS system.
Results: There have been no failures and radiologically, serial X-rays demonstrate osseo-integration at an early stage.
We have had no cases of deep infection but there have been 3 femoral peri-prosthetic fractures, (1 late) and 2 dislocations.
All patients have been allowed early weight bearing and those patients with over 12 months follow up have an improved Merle d’Aubigne score.
Discussion: The biomechanical properties of Trabecular metal and a modular design permit a press fit technique supplemented by dome screws combined with the possibility of using varying sizes of liner to minimise dislocation or to retain well fixed femoral stems in revision surgery.
The ease of use of the implant has now led to us largely abandoning other reconstructive techniques such as impaction allo-grafting or cages in revision or complex primary hip surgery.
We consider Trabecular metal to be a major advance in acetabular reconstruction on the basis of our initial experience
Correspondence should be addressed to Mr John Hodgkinson, BHS, c/o BOA, The Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PE.
