Abstract
Total hip arthroplasty (THA) revision rates remain high and are expected to increase.
Different ingrowth surfaces including tantalum and titanium have been introduced to
improve fixation and survival. Promising results have been shown with tantalum. This
study was conducted to compare the survivorship of titanium and tantalum components
after revision THA. A retrospective review of all THA revision cases from January
2002 to December 2010 was performed. Cases, where the questioned components were used,
were enlisted in a single continuous cohort. A minimum of 2-year follow-up was required
for inclusion. Patients were compared in two groups: titanium versus tantalum components,
with the endpoint defined as any failure requiring acetabular component removal. A
total of 118 patients were analyzed and included 64 patients in the tantalum group
and 56 patients in the titanium group. The average length of follow-up was 50.4 months
for both groups. Cases, where tantalum implants were used, were more likely to have
a worse acetabular bone loss (p = 0.005). The main cause of index revision was aseptic loosening followed by infection.
At the latest follow-up, survivorship was very similar in appearance and failed to
achieve statistical difference (log-rank p = 0.1146). Among the variables assessed as potential predictors of failure, only
the number of prior revisions was statistically significant (p = 0.004). The high-porosity titanium acetabular components demonstrate same survivorship
at 2-year follow-up as the tantalum cups in the setting of revision THA. Only the
number of prior revisions was significantly associated with increased failure rate.
Keywords
total hip arthroplasty - high porosity - survivorship
