Periacetabular bone densitometry after total hip arthroplasty with highly porous titanium cups: a 2-year follow-up prospective study



Trabecular Titanium is an advanced cellular solid structure, composed of regular multiplanar hexagonal interconnected cells that mimic the morphology of the trabecular bone. This biomaterial demonstrated improved mechanical properties and enhanced osteoinduction and osteoconduction in several in vitro and in vivo studies. The aim of this study was to assess Trabecular Titanium osseointegration by measuring periacetabular changes in bone mineral density (BMD) with dual-emission X-ray absorptiometry (DEXA).


89 patients (91 hips) underwent primary total hip arthroplasty (THA) with acetabular Trabecular Titanium cups. Clinical (Harris Hip Score (HHS), SF-36) and radiographic assessment were performed preoperatively, and postoperatively at 7 days and at 3, 6, 12 and 24 months. DEXA analysis was performed only postoperatively, using the BMD values measured at 7 days as baselines.


After an initial decrease from baseline to 6 months, BMD increased and progressively stabilised in all 3 regions of interest (ROIs). Median (IQR) HHS and SF-36 increased from 48 (39-62) and 49 (37-62) preoperatively to 99 (96-100) and 86 (79-92) at 24 months, indicating a considerable improvement in terms of pain relief, functional recovery and quality of life. BMD patterns and radiographic evaluation showed evident signs of periacetabular bone remodelling and osseointegration; all cups were stable at the final follow-up without radiolucent lines, loosening or osteolysis. No revisions were performed.


After an initial reduction in periacetabular BMD, all 3 ROIs exhibited stabilisation or slight recovery. Although clinical outcomes and functional recovery proved satisfactory, longer follow-ups are necessary to assess this cup long-term survivorship.

Hip Int 2017; 27(6): 551 - 557




Leo Massari, Alessandro Bistolfi, Pier Paolo Grillo, Alda Borré, Gaetano Gigliofiorito, Carlotta Pari, Andrea Francescotto, Piermario Tosco, Davide Deledda, Laura Ravera, Araldo Causero

Article History


Financial support: This clinical investigation was sponsored by Lima Corporate.
Conflict of interest: L.M. was consultant for Lima Corporate. All other authors have no conflict of interest.

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  • University Hospital of Ferrara “S. Anna”, Ferrara - Italy
  • Department of Orthopaedics, Traumatology and Rehabilitation, Clinic II, University Hospital of Turin “Città della Salute e della Scienza di Torino”, Turin - Italy
  • Department of Orthopaedics, Traumatology and Rehabilitation, Clinic I, University Hospital of Turin “Città della Salute e della Scienza di Torino”, Turin - Italy
  • Radiodiagnostic Orthopaedic Traumatology Centre, University Hospital of Turin “Città della Salute e della Scienza di Torino”, Turin - Italy
  • University Hospital of Udine “Santa Maria della Misericordia”, Udine - Italy

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