Do tantalum and titanium cups show similar results in revision hip arthroplasty?

Abstract

Porous surfaces are intended to enhance osteointegration of cementless implants. Tantalum has been introduced in an effort to enhance osseointegration potential of uncemented components. We therefore compared the clinical outcome of acetabular components with two different porous surfaces. We retrospectively reviewed 283 patients (295 hips) who underwent cementless revision hip arthroplasty with either an HA-coated titanium cup (207 patients, 214 hips) or porous tantalum cup (79 patients, 81 hips). The minimum followup was 24 months in both groups (titanium: average 51.8 months, range, 24-98 months; tantalum: average, 35.4 months, range, 24-63 months). The titanium and tantalum groups had a mechanical failure rate (clinical plus radiographic) of 8% and 6%, respectively. In hips with minor bone deficiency (type 1, 2A, 2B using the classification of Paprosky et al.), 6% of titanium cups and 4% of tantalum cups failed. In hips with major bone deficiency (type 2C, 3), 24% of titanium cups and 12% of tantalum cups developed failure. In the major bone deficiency group, the tantalum cups had fewer numbers of lucent zones around the cup. Eighty-two percent of titanium cups that failed did so at 6 months postoperatively or later, whereas 80% of tantalum cups that failed did so in less than 6 months. Radiographically in the major group, tantalum cups yielded better fixation.

Level of evidence: Level III, retrospective comparative study. See the Guidelines for Authors for a complete description of levels of evidence.

Figures

Fig. 1

The distribution of the titanium and tantalum cups in the groups of Paprosky et al. classification is shown in this figure.

Fig. 2

This figure shows the Kaplan-Meier survivorship for titanium and tantalum acetabular cups with revision or definite radiographic loosening of the acetabular component as the end point. The survivorships of these two components were similar.