Retrospective Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Mar 18, 2025; 16(3): 100481
Published online Mar 18, 2025. doi: 10.5312/wjo.v16.i3.100481
Trabecular titanium acetabular cup in patients with medial femoral neck fracture: Survivorship analysis and clinical and radiological outcomes
Eugenio Jannelli, Ester Boggio, Alberto Castelli, Gianluigi Pasta, Federico Alberto Grassi, Mario Mosconi
Eugenio Jannelli, Ester Boggio, Federico Alberto Grassi, Mario Mosconi, Orthopedics and Traumatology Clinical Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, IRCCS Policlinico San Matteo Foundation, Pavia 27100, Lombardy, Italy
Alberto Castelli, Gianluigi Pasta, Department of Orthopedic and Traumatology Clinic, IRCCS Policlinico San Matteo Foundation, Pavia 27100, Lombardy, Italy
Author contributions: Jannelli E, Boggio E contributed to study design, first draft of the paper; Boggio E, Pasta G contributed to recruitment and data collection; Mosconi M, Castelli A, Grassi FA contributed to data analysis and interpretation. All authors revised the paper.
Institutional review board statement: The study was reviewed and approved by our Institutional review board (n°20150001442).
Informed consent statement: All study participants or their legal guardian provided informed written consent regarding personal and medical data collection prior to study enrolment.
Conflict-of-interest statement: All the authors have no conflict of interest related to the manuscript.
Data sharing statement: No dataset is available.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ester Boggio, Doctor, Orthopedics and Traumatology Clinical Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, IRCCS Policlinico San Matteo Foundation, Viale Camillo Golgi 19, Pavia 27100, Lombardy, Italy. ester.boggio@gmail.com
Received: August 17, 2024
Revised: December 8, 2024
Accepted: February 19, 2025
Published online: March 18, 2025
Processing time: 206 Days and 12.4 Hours
Abstract
BACKGROUND

Clinical studies using Trabecular Titanium™ acetabular cups have shown promising short and medium-term results. This material, due to its macro and micro surface roughness, provides a substrate for osseointegration and enhances implant stability. However, there is a lack of evidence in the literature on the use of this material in patients with femoral neck fracture.

AIM

To evaluate the short-term clinical-functional and radiographic outcomes in patients with femoral neck fractures undergoing total hip arthroplasty (THA) with Trabecular Titanium™ acetabular cup implants.

METHODS

The study included 104 patients with medial femoral neck fractures who underwent THA between January 2020 and December 2020 with the Delta TT acetabular cup (Lima Corporate, Villanova di San Daniele del Friuli, Italy). The mean age of the patients was 69.57 ± 10.16 years (range: 36-85 years). The follow-up period ranged from a minimum of 3 to a maximum of 4 years. Three questionnaires (Harris Hip Score, Oxford Hip Score, and EQ5D) were administered along with radiographic evaluations. Statistical methods included the Student's t-test and one-way analysis of variance for comparisons (with significance set at 0.05), and the Kaplan-Meier curve for prosthetic implant survival.

RESULTS

The mean follow-up was 41.5 months. The Harris Hip Score (HHS) showed a mean increase of 2.74 points (mean HHS 88.52 at 6 months postoperatively and mean HHS 91.26 at the last follow-up) with statistical significance. Similarly, the Oxford Hip Score demonstrated a statistically significant difference between follow-up groups. However, the EQ5D did not show statistically significant differences among the three groups (preoperative, 6-month follow-up, and last follow-up). Revision surgery was required in 6 patients. According to Moore's criteria, 96% of the acetabular components were radiographically stable and well-integrated at the last follow-up. The Kaplan-Meier curve showed a 96% survival rate.

CONCLUSION

The clinical and radiographic results obtained in the short to medium term confirm the excellent performance of the Delta TT acetabular cup in terms of osseointegration, providing an optimal solution both for young patients with high functional recovery demands and for fragile patients requiring optimal stability of the acetabular component to reduce the risk of implant failure.

Keywords: Trabecular titanium acetabular cups; Hip arthroplasty; Femur neck fracture; Engh classification; PROMs

Core Tip: This retrospective study assessed the outcomes of 104 patients with medial femoral neck fractures treated with total hip arthroplasty using Trabecular Titanium™ acetabular cups. With an average follow-up of 41.5 months, the results showed significant improvements in Harris Hip and Oxford Hip Scores, indicating successful clinical outcomes. The EQ5D score showed no significant differences. Radiographic evaluations revealed 96% implant stability, and the Kaplan-Meier curve indicated a 96% survival rate. The Delta TT acetabular cup demonstrated excellent performance in osseointegration and stability, making it suitable for both young, active patients and older, fragile individuals.