BACKGROUND: We evaluated bone volume fraction in retrieved acetabular shells with 2 types of porous coatings: (1) titanium fiber mesh (HG) components and (2) tantalum metal coating (TM) components. METHODS: Eight HG shells were matched to 8 TM shells for patient age, body mass index, and gender. The mean age at index surgery was 69 (51-82) years, mean body mass index was 28 (21-40), and patients were evenly divided between male and female (4:4). The length of implantation was 40 (16-96) months for the TM group and 156 (108-216) months for the HG group. Shells were embedded and two 5-mm thick cross-sections were cut through the apex of each component for backscatter scanning electron microscopy assessment. Backscatter scanning electron microscopy images were segmented to threshold for metal, bone, and available space for ingrowth. Slices were assessed regionally for ingrowth at the rim, equator, and pole of the acetabular shell. Differences were assessed using general estimating equations, and P values were adjusted for multiple comparisons using the Holm-Bonferroni step-down procedure. RESULTS: The mean bone volume fraction was 21 ± 17% for the HG shell and 7 ± 4% for the TM shell (P < .0001). The rim and pole regions both had less bone ingrowth than the equator. No association was found between bone ingrowth and length of implantation for either design. CONCLUSION: Adequate bone ingrowth is a requirement for successful biological fixation, but the amount of ingrowth may not be a driving factor. Both implants studied had successful outcomes and long-term fixation despite the observation of low amounts of ingrowth.
BACKGROUND: We evaluated bone volume fraction in retrieved acetabular shells with 2 types of porous coatings: (1) titanium fiber mesh (HG) components and (2) tantalum metal coating (TM) components. METHODS: Eight HG shells were matched to 8 TM shells for patient age, body mass index, and gender. The mean age at index surgery was 69 (51-82) years, mean body mass index was 28 (21-40), and patients were evenly divided between male and female (4:4). The length of implantation was 40 (16-96) months for the TM group and 156 (108-216) months for the HG group. Shells were embedded and two 5-mm thick cross-sections were cut through the apex of each component for backscatter scanning electron microscopy assessment. Backscatter scanning electron microscopy images were segmented to threshold for metal, bone, and available space for ingrowth. Slices were assessed regionally for ingrowth at the rim, equator, and pole of the acetabular shell. Differences were assessed using general estimating equations, and P values were adjusted for multiple comparisons using the Holm-Bonferroni step-down procedure. RESULTS: The mean bone volume fraction was 21 ± 17% for the HG shell and 7 ± 4% for the TM shell (P < .0001). The rim and pole regions both had less bone ingrowth than the equator. No association was found between bone ingrowth and length of implantation for either design. CONCLUSION: Adequate bone ingrowth is a requirement for successful biological fixation, but the amount of ingrowth may not be a driving factor. Both implants studied had successful outcomes and long-term fixation despite the observation of low amounts of ingrowth.
Authors: Vignesh K Alamanda; Ivan Demartino; Hollis G Potter; Matthew F Koff; Bin Lin; Ahava Muskat; Geoffrey H Westrich Journal: Arthroplast Today Date: 2020-08-26