International Orthopaedics

, Volume 43, Issue 8, pp 1815–1821 | Cite as

Highly porous titanium cup in cementless total hip arthroplasty: registry results at eight years

  • Francesco CastagniniEmail author
  • Barbara Bordini
  • Susanna Stea
  • Pierina Paola Calderoni
  • Claudio Masetti
  • Luca Busanelli
Original Paper



Highly porous cups were developed to improve osseointegration and reduce the rate of aseptic loosening. Highly porous titanium cups could mix the reliability of titanium metal with an enhanced porosity, improving the bony ingrowth. The aim of this report was to assess the survival rates and reasons for revision of a highly porous titanium cup, Fixa Ti-Por (Adler Ortho, Milan, Italy), fabricated using an additive manufacturing.


The Registry of Prosthetic Orthopedic Implants (RIPO), the Emilia-Romagna region arthroplasty registry, was enquired about cementless cups, implanted since July 2007. Ti-Por cups were compared to all the other cementless sockets, acting as a control group. The survival rates and reasons for revision were evaluated and compared. Comparisons with the same articular couplings were also provided.


When all the articular couplings were included, Ti-Por performed better, achieving a statistically higher survival rate than the control group (98.7% vs 97.9%) and a statistically lower incidence of cup aseptic loosening. In case of ceramic on polyethylene couplings, Ti-Por achieved similar survival rate: cup aseptic loosening in Ti-Por group was 0.2%, whereas the control group rated 0.4%. In ceramic-on-ceramic implants, the survival rate was similar in the two groups, Ti-Por achieving a cup aseptic loosening rate of 0.1% (vs 0.14% in the control group).


Highly porous titanium cups showed trustworthy results at eight years, reducing the rate of aseptic loosening. Longer follow-ups, ion analyses, and pre-clinical in vivo studies would be helpful to better define the reliability of these devices and their advantages.


Trabecular Titanium Aseptic loosening Pore Additive manufacturing Ti-Por 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

Ethical approval was not necessary as the registry collects personal data as standard practice and conceals the identity of the patients.


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Copyright information

© SICOT aisbl 2018

Authors and Affiliations

  1. 1.Ortopedia-Traumatologia e Chirurgia protesica e dei reimpianti d’anca e di ginocchioIRCCS Istituto Ortopedico RizzoliBolognaItaly
  2. 2.Laboratorio di Tecnologia MedicaIRCCS Istituto Ortopedico RizzoliBolognaItaly

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