Between 2008 and 2011, 109 Delta TT cups in Trabecular Titanium^TM were implanted in 98 patients, 65 males and 43 females, with an average age of 63 and 65 years respectively at the time of surgery. The acetabular component was coupled to different types of stems. All patients were evaluated both radiographically and clinically with the Harris Hip Score (HHS) at the pre-operative examination, at 3, 6 months after surgery and then yearly.

The current mean follow-up is 15 months (min. 2, max. 36). The total mean HHS value and all specific domains significantly improved from pre-operative evaluation to the last follow-up. The X-rays revealed no signs of loosening or migration of the cups, nor periacetabular signs of osteolysis. The inclination angle was within the physiological range of 40± 5degrees of coverage in all cases. One case of revision was necessary due to early septic loosening. A staged re-operation was planned: on removing the cup, there was no evidence of osteointegration due to the local infection. In another case of revision due to recurrent dislocation, the cup appeared to be completely osteointegrated therefore was not removed. The surgeon opted to cement a retention cup into the original acetabular implant. All other patients presented satisfactory clinical outcomes and none complained of persistent pain or any other discomfort related to the prosthetic implant.

Initially, the DELTA-TT cup was to be implanted in the younger and most active patients with good acetabular bone stock. Then, thanks to the high osteointegrating potential of the Trabecular Titanium^TM, the indication was further extended to older patients with poroticacetabular bone stock. Hip reinforcement screws were used in 7 cases, never for evident micro-instability (as may occur with other implants), but only as a further safety measure in porotic bone. Besides primary and secondary stability, another advantage of this acetabular cup is the possibility of using ceramic, metal or polyethylene liners, depending on the patient’s needs and clinical condition.

The DELTA-TT cup provides immediate satisfactory results and guarantees excellent primary press-fit stability both in young patients with good bone stock quality and in elderly patients with poor one. As for all new biomaterials, it is mandatory to continue the clinical and radiographic follow-up going forward.