Tritanium® Primary Acetabular Shell Study

A Prospective, Post-market, Multi-center Study of the Tritanium® Acetabular Shell

This study will be a prospective, non-randomized evaluation of the Tritanium® Acetabular Shell for primary total hip replacement (THR) with a cementless application in a consecutive series of patients who meet the eligibility criteria. Half of the cases will use the Trident® X3® polyethylene insert alone as the bearing surface; the other half will use the modular dual mobility (MDM™) liner coupled with a compatible anatomic dual mobility (ADM™)/MDM™ X3® insert as the bearing surface.

The success rate, defined as freedom from acetabular revision for any reason, for hips implanted with the Tritanium® Acetabular Shell, is no worse than for hips implanted with similar technology as reported in the literature and Trident® X3® Study historical control at 5 years postoperative.

Study Overview

• Status: Terminated
• Conditions: Arthroplasty, Replacement, Hip
• Intervention / Treatment: Device: Tritanium® Primary Acetabular Shell

Detailed Description

The Tritanium® Acetabular Shell, cleared for use under FDA 510(k) K081171, is a hemispherical acetabular shell with a 3D surface for biological fixation, fabricated from Commercially Pure Titanium (CPTi). The shell is built upon the design features and clinical history of the existing Trident® Tritanium®, Trident® AD, and Trident® hemispherical acetabular (HA) shells. The device is designed with a roughened surface and high coefficient of friction to resist micromotion and promote initial fixation. The Tritanium® Acetabular Shell, intended for use in a cementless application, is available in sizes from 44 millimeter (mm) through 66 mm and is compatible with Trident® polyethylene insert and acetabular screws. This advanced technology is designed to address the need for improved initial and biological fixation. Data in support of these marketing claims will be collected in the Tritanium® Primary Acetabular Shell Study.

A prospective, post-market, multi-center design will be employed. Radiographs will be assessed by an independent reviewer.

Cases will be enrolled at 7 to 12 centers. The enrollment goal ranges from 20 to 34 cases implanted with the Tritanium® Acetabular Shell per center. The enrollment goal range is dependent upon the number of participating centers as well as the relative rates of enrollment of the two treatment groups. Although a range is presented, there is no maximum limit to the number of cases that a center may enroll. In the event that a center far exceeds the overall enrollment goal or enrollment into one of the treatment groups is completed, Stryker may ask the center to cease enrollment so as not to skew the data. All participating centers will comply with the federal regulations regarding patient informed consent and Institutional Review Board (IRB) approval. Non-compliance of a study center may result in termination of the center's participation in the study.

• Study Type: Interventional
• Enrollment (Actual): 275
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • California
    • Saint Helena, California, United States, 94574
      • Adventist Health St. Helena
  • Florida
    • Tampa, Florida, United States, 33542
      • Florida Medical Clinic
  • Kentucky
    • Lexington, Kentucky, United States, 40536
      • University of Kentucky Research Foundation
  • Louisiana
    • Lake Charles, Louisiana, United States, 70601
      • Center for Orthopaedics and Spine, LLP
  • Maine
    • Bangor, Maine, United States, 04401
      • Northern Light Eastern Maine Medical Center
  • New York
    • Syracuse, New York, United States, 13214
      • Syracuse Orthopedic Specialists, P.C.
  • West Virginia
    • Morgantown, West Virginia, United States, 26506
      • West Virginia University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• A. Patient has signed an IRB approved, study specific Informed Patient Consent Form.
• B. Patient is a male or non-pregnant female age 18 years or older at time of study device implantation.
• C. Patient has primary diagnosis of Non-Inflammatory Degenerative Joint Disease (NIDJD).
• D. Patient is a candidate for a primary cementless total hip replacement.
• E. Patient is willing and able to comply with postoperative scheduled clinical and radiographic evaluations and rehabilitation.

Exclusion Criteria:

• F. Patient has a Body Mass Index (BMI) ≥ 40.
• G. Patient has an active or suspected latent infection in or about the affected hip joint at time of study device implantation.
• H. Patient has a neuromuscular or neurosensory deficiency, which limits the ability to evaluate the safety and efficacy of the device.
• I. Patient is diagnosed with a systemic disease (e.g. Lupus Erythematosus) or a metabolic disorder (e.g. Paget's Disease) leading to progressive bone deterioration.
• J. Patient is immunologically suppressed or receiving steroids in excess of normal physiological requirements (e.g. > 30 days).
• K. Patient requires revision surgery of a previously implanted total hip replacement or hip fusion to the affected joint.
• L. Patient has a known sensitivity to device materials.
• M. Patient is a prisoner.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Other: Tritanium® Primary Acetabular Shell	Device: Tritanium® Primary Acetabular Shell; Tritanium® Primary Acetabular Shell in total hip replacement.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Absence of Acetabular Revision	To evaluate the success rate of cementless primary total hip replacement (THR) in hips implanted with the Tritanium® Acetabular Shell, as compared to the published results of similar acetabular components. Success will be defined as absence of acetabular shell revision for any reason at 5 years postoperative. It is expected that the survivorship of the Tritanium® Acetabular Shell group will be non-inferior to the survivorship reported in the literature for similar competitive devices.	5 years

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Harris Hip Score	The Harris Hip Score (HHS) assesses pain, function, joint deformity and range of motion. Scores can range from 0 to 100 with 0 being the worst and 100 being the best score. A score of 80-100 is considered good-excellent and a score of less than or equal to 79 is considered fair-poor. 90-100 = excellent 80-89 = good 70-79 = fair 0-69 = poor	1, 3, and 5 years
Lower Extremity Activity Scale (LEAS) Score	The LEAS is completed by the participant to assess activity level. Activity levels were ordered in terms of intensity from 1 to 18, with 18 indicating the highest activity level.	1, 3, and 5 years
Follow-Up Questionnaire	The Follow-up Questionnaire is a short patient questionnaire intended to provide information on patient satisfaction, pain, and whether or not there have been any revisions or removals since the last follow-up visit. It consists of three questions: Patient satisfaction with the hip replacement; Presence of any pain in the study hip; Any surgeries performed on the study hip	6, 7, 8, 9, and 10 years
Acetabular Shell Radiographic Stability	Numerous parameters will be reviewed by zone, including radiolucency and migration. All data will be evaluated in order to classify each case as stable or unstable.	6 weeks, 1, 3, 5 years
Short Form- 12 (SF-12) Heath Survey Scores	The SF-12 Health Survey is a 12-item patient completed questionnaire to measure general health and well-being. It includes a physical and mental status component score; each ranging from 0-100. Low values represent a poor health state and high values represent a good health state.	1, 3, and 5 years
Rates of Screw Fixation Usage in the Tritanium® Acetabular Shell	Usage of bone screw fixation will be recorded and compared between the Tritanium® Acetabular Shell group and the Trident® Hemispherical Acetabular (HA) Shell group (Trident® X3® Polyethylene Insert Study).	Intraoperative
EuroQol Five-Dimensional (EQ-5D)	The EuroQol five-dimensional (EQ-5D) is a subject-completed questionnaire designed to assess subject health state values. The EQ-5D consists of 2 areas: the EQ visual analogue scale (EQ VAS) and EQ-5D descriptive system. The EQ VAS collects health state values using a 20 cm visual analogue scale with the endpoints labeled best imaginable health state at the top and worst imaginable health state at the bottom, having numeric values of 100 to 0 respectively. The EQ-5D Time Trade-off (TTO) descriptive system comprises the following five dimensions: mobility, self-care, usual activities, pain/comfort and anxiety/depression. Each dimension has three levels: no problems, some problems and extreme problems, where an overall score of 1 represents full health. The index values on a scale between -1 (low) and 1 (high) are showing the average health status. A low score shows worse health, and a high score shows better health.	1,2,3,4, and 5 years

Collaborators and Investigators

• Sponsor: Stryker Orthopaedics
• Investigators: Principal Investigator: John Noble, MD, Center for Orthopaedics and Spine, LLP; Principal Investigator: Carmen Crofoot, MD, Northern Light Eastern Maine Medical Center; Principal Investigator: Kevin Kopko, MD, Syracuse Orthopedic Specialists, P.C.; Principal Investigator: John Diana, MD, Adventist Health St. Helena; Principal Investigator: Stephen Duncan, MD, University of Kentucky Research Foundation; Principal Investigator: Brock Lindsey, MD, West Virginia University; Principal Investigator: Stephen Raterman, MD, Florida Medical Clinic

Study record dates

Study Major Dates

• Study Start: July 1, 2011
• Primary Completion (Actual): May 5, 2022
• Study Completion (Actual): December 30, 2023

Study Registration Dates

• First Submitted: February 4, 2010
• First Submitted That Met QC Criteria: February 4, 2010
• First Posted (Estimated): February 5, 2010

Study Record Updates

• Last Update Posted (Actual): April 16, 2025
• Last Update Submitted That Met QC Criteria: March 28, 2025
• Last Verified: December 1, 2024

More Information

Terms related to this study

• Keywords: Osteoarthritis; Avascular Necrosis; Traumatic arthritis
• Other Study ID Numbers: 69