Trabecular metal technology (TMT) cups in primary total hip arthroplasty: outcomes and survivorship of a large cohort

Total hip arthroplasty (THA) is a widely performed procedure presenting substantial functional improvement in patients with hip joint pathology. Cementless acetabular components have well renowned popularity for their potential for long-term durability and bone preservation. Among these implants, trabecular metal technology (TMT), particularly using tantalum, has been introduced to enhance biological fixation and implant longevity. This retrospective study analyzed 3464 primary THAs performed using tantalum TMT acetabular cups between 2012 and 2022 at a single high-volume arthroplasty center. Patients included were adults undergoing THA for osteoarthritis, hip dysplasia, post-traumatic arthritis, or avascular necrosis, with a minimum follow-up of 24 months. Clinical outcomes were evaluated using the Harris Hip Score (HHS), and implant survivorship was assessed via Kaplan–Meier analysis. The mean follow-up was 7.03 years (± 2.58). The mean HHS improved significantly from 46.7 (± 7.2) preoperatively to 91.07 (± 7.8) at final follow-up. The implant survivorship free from any reoperation was 97.78%, while survivorship free from aseptic loosening was 99.89%. Radiographically, mean cup inclination was 41.3° (± 5.9), with signs of potential aseptic loosening in only four cases (0.11%). Complications included 46 infections managed with DAIR/DAPRI and 30 implant-related revisions, primarily due to dislocation or mechanical failure. Tantalum acetabular components demonstrate excellent mid-term clinical and radiographic performance in a broad patient population, suggesting their utility in both high-demand and compromised bone quality cases. Continued follow-up is necessary to confirm long-term implant survivorship.