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

Introduction: 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. Methods: 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. Results: 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. Conclusion: 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.