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

Abstract

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. 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. 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. 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.