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Case Reports
. 2018 Jan 2;4(2):169-174.
doi: 10.1016/j.artd.2017.11.009. eCollection 2018 Jun.

Early aseptic loosening of the Tritanium primary acetabular component with screw fixation

William J Long  1 , Samir Nayyar  1 , Kevin K Chen  1 , David Novikov  1 , Roy I Davidovitch  1 , Jonathan M Vigdorchik  1
Affiliations
Case Reports

Early aseptic loosening of the Tritanium primary acetabular component with screw fixation

William J Long et al. Arthroplast Today. .

Abstract

Ultraporous acetabular components were developed to improve osseointegration and fit for increased longevity and better outcomes after total hip arthroplasty. There is a paucity of literature detailing this acetabular component's clinical performance, with even less detailing those with screw fixation. We identify 5 patients at our institution who underwent revision total hip arthroplasty for early aseptic acetabular cup loosening of an ultraporous acetabular component known as the Tritanium primary cup with secondary screw fixation. They all presented with groin and hip pain after index surgery and underwent follow-up radiographic examination consistent with component loosening requiring revision surgery. This case series reports on the risk of early acetabular cup loosening and its associated clinical presentation, workup, and surgical management in patients with the Tritanium primary cup augmented with screws.

Keywords: Acetabular cup loosening; Total hip arthroplasty; Tritanium primary cup; Ultraporous acetabular component.

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Figures

Figure 1
Figure 1
(a) Anteroposterior (AP) radiograph of case 1 demonstrating complete radiolucency in zones 1-3 at 1 year after primary THA. (b) Axial view of a computed tomography scan of case 1 demonstrating a complete radiolucent line in all zones (white arrowheads) 14 months after primary THA. (c) Coronal view of a computed tomography scan of case 1 demonstrating a complete radiolucent line in all zones (white arrowheads) 14 months after primary THA. (d) AP radiograph of case 1 demonstrating no evidence of radiolucency 13 months after revision THA. (e) Coronal view of a computed tomography scan of case 1 demonstrating no evidence of radiolucency 13 months after revision THA.
Figure 2
Figure 2
(a) AP radiograph of case 4 demonstrating no radiolucency 3 months after primary THA. (b) AP radiograph of case 4 demonstrating circumferential radiolucency in all 3 Charnley zones 3.5 years after primary THA. (c) AP radiograph of case 4 demonstrating no sign of loosening 2 months after revision THA.
Figure 3
Figure 3
(a). AP radiograph of case 5 demonstrating circumferential radiolucency (white arrowheads) 6 months after primary THA. (b). AP radiograph of case 5 demonstrating no evidence of loosening or radiolucency after revision THA.
Figure 4
Figure 4
Removed Tritanium acetabular shell from case 5 that was grossly loose intraoperatively.
See this image and copyright information in PMC

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