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DELTA TT

The DELTA TT is a hemispherical cementless acetabular cup manufactured in Trabecular Titanium through the process of additive manufacturing. Breaking new ground in orthopedic technology, it combines the unique features of the DELTA System with the Trabecular Titanium structure.

TT Trabecular Titanium ingrowths surface

Full hemispherical profile

State of the art bearing options including DELTA Dual Mobility

About

The DELTA TT cup breaks new ground in orthopedic technology by combining the unique features of the DELTA System with the TT Trabecular Titanium structure.

TT Trabecular Titanium allows for primary stability and bone ingrowth [2,3,4,5]. Optional bone screws can be used to support stability in cases of insufficient bone [2]. The full hemispherical profile with a press-fit of 1mm provides initial close contact with viable native bone [2,4]. LimaCorporate’s leading technology provides a unique titanium alloy component with material continuity from the core to dome, replicating the cone structure on order to optimise mechanical resistance [6,7]. DELTA cups offer close contact between bone and TT Trabecular Titanium helping to achieve a stable primary stability, laying the foundation for secondary fixation [4]. Its Macro Roughness supports the high friction with bone to maximise primary stability enhancing bone integration [11]. The cup’s micro roughness encourages the attachment, proliferation and differentiation of anchorage-dependent bone forming cells[12]. Since 1978 LimaCorporate has adopted a taper connection between liners and cups for a more stable coupling with almost 20º angle for a self-locking system [13]. The unique polar peg technology facilitates the correct insertion of the liners into the acetabular cups for correct orientation and self-locking. Liner offerings provide BIOLOX^®delta, xLima, LimaVit™ and DELTA dual mobility liners. TT Trabecular Titanium offers the scaffold for cell colonisation and bone tissue vascularisation. An optimal porosity and pore size promote enhanced vascularisation and mineralisation, favouring new bone formation [14,15]. Stem cells (hASCs] grown on TT Trabecular Titanium scaffolds have shown to adhere, proliferate and differentiate into osteoblasts, even in the absence of osteogenic factors [16,17]. Histomorphometric analysis in a sheep model comparing TT Trabecular Titanium with traditional coatings proved that TT Trabecular Titanium favours direct osteogenesis with high osseointegration [18]. TT Trabecular Titanium provides 87% bone in-growth in cortical bone ad 68% in cancellous bone [18].

BIBLIOGRAPHY [1] Ashby MF, Evans A., Fleck NA, Gibson LJ, Hutchinson JW, Wadley HNG. Metal foams: a design guide. Woburn (MA, USA): Butterworth-Heinemann; 2000. [2] Bistolfi A, Ravera L, Graziano E, Collo G, Malino D, Giordano A, Massazza G. A Trabecular Titanium™ cup for total hip arthroplasty: a preliminary clinical and radiographic report. Minerva Ortop Traumatol. 2014 Apr;65(2):199-205. [3] Massari L, Bistolfi A, Grillo PP, Borré A, Gigliofiorito G, Pari C, Francescotto A, Tosco P, Deledda D, Ravera L, Causero A. Periacetabular Bone Densitometry After Total Hip Arthroplasty with Highly Porous Titanium Cups: A Two-Year Follow-Up Prospective Study. Hip Int. 2017;27(6):551-7. [4] Perticarini L, Zanon G, Rossi SM, Benazzo FM. Clinical and radiographic outcomes of a trabecular titanium™ acetabular component in hip arthroplasty: results at minimum 5 years follow-up. BMC Musculoskelet Disord. 2015 Dec 3;16:375. [5] Shultz TR, Blaha JD, Gruen TA, Norman TL. Cortical bone viscoelasticity and fixation strength of press-fit femoral stems: finite element model.J Biomech Eng. 2006;128(1):7-12. [6] Medlin DJ, Scrafton J, Shetty R. Metallurgical attachment of a porous tantalum foam to a titanium substrate for orthopaedic applications. Journal of ASTM International. 2005;2(10):30-9. [7] Marin E, Fusi S, Pressacco M, Paussa L, Fedrizzi L. Characterization of cellular solids in Ti6Al4V for orthopaedic implant applications: Trabecular titanium. J Mech Behav Biomed Mater. 2010;3(5):373–81. [8] Ding M, Dalastra M, Danielsen CC, Kabel J, Hvid I, Linde F. Age variations in the properties of human tibial trabecular bone. J Bone Joint Surg Br. 1997;79-B(6):995-1002. [9] William D. Callister Jr. Materials Science and Engineering an introduction. 6th Edition. Hoboken (NJ, USA): Wiley; 2002. [10] MatWeb. Material Property Data [Internet]. Blacksburg (VA, USA): MatWeb LLC; [cited 2014 May 14th]. Available from: www.matweb.com. [11] Marin E, Fedrizzi L, Regis M, Pressacco M, Zagra L, Fusi S. Stability Enhancement Of Prosthetic Implants: Friction Analysis Of Trabecular Titanium. Hip Int. 2012;403:427-428. [12] Mour M, Das D, Winkler T, Hoenig E, Mielke G, Morlock MM, Schilling AF. Advances in porous biomaterials for dental and orthopaedic applications. Materials. 2010:3:2947-74. [13] Dalla Pria P. New modular system in total hip arthroplasty: the Lima Group’s experience in modularity. J Orthopaed Traumatol. 2004 Apr;5(1):S20–S21. [14] Karageorgiou V, Kaplan D. Porosity of 3D biomaterial scaffolds and osteogenesis. Biomaterials. 2005;26(27):5474-91. [15] Frosch KH, Barvencik F, Viereck V, Lohmann CH, Dresing K, Breme J, Brunner E, Stürmer KM. Growth behavior, matrix production, and gene expression of human osteoblasts in defi ned cylindrical titanium channels. J Biomed Mater Res A. 2004;68(2):325-34 [16] Gastaldi G, Asti A, Scaffi no MF, Visai L, Saino E, Cometa AM, Benazzo F. Human adipose-derived stem cells (hASCs) proliferate and differentiate in osteoblast-like cells on trabecular titanium scaffolds. J Biomed Mater Res A. 2010;94(3):790-9. [17] Benazzo F, Botta L, Scafﬁ no MF, Caliogna L, Marullo M, Fusi S, Gastaldi G. Trabecular Titanium can induce in vitro osteogenic differentiation of human adipose derived stem cells without osteogenic factors. J Biomed Mater Res Part A. 2014:102A:2061–71. [18] Devine D, Arens D, Burelli S, Bloch HR, Boure L. In vivo evaluation of the osteointegration of new highly porous Trabecular Titanium™. J Bone Joint Surg Br. 2012;94-B(Suppl XXXVII):201. [19] Biggi S, Gramazio M, Tornago S, Cattaneo G, Camera A. Trabecular titanium acetabular cup with ceramic-on-ceramic bearing in primary total hip arthroplasty. A ten-years single center study. Giornale Italiano di Ortopedia e Traumatologia 2017;43:138-43. [Italian]Giornale Italiano di Ortopedia e Traumatologia 2017;43:138-43. [Italian] Trabecular Titanium™. J Bone Joint Surg Br. 2012;94-B(Suppl XXXVII):201.

Sizing and Options

Vitamin E (a-tocopherol) is an effective biological antioxidant that helps preventing the oxidative degradation of cells’ membrane phospholipids, hence the polymer, while ensuring ultra-low wear and maintaining greater mechanical strength over time compared to standard UHMWPE.

Bibliography: Exponent (2015). Material Characterization of Limacorporate S.p.A.’s Vitamin E Blended 100 kGy UHMWPE. Appendix 13b.

Clinical Papers

Aiba H, Watanabe N, Inagaki T, Fukuoka M, Murakami H.

Differences among the observers in the assessments of Japanese orthopedic association hip scores between surgeons and physical therapists and the correlations to patients’ reported outcomes after total hip arthroplasty. BMC Musculoskelet Disord. 2022 Jan 03; 23:27

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Bistolfi A, Ferracini R, Aprato A, Massè A, Daghino W, Lea S, Artiaco S, Lee GC

Third generation delta ceramic-on-ceramic bearing for total hip arthroplasty at mid-term follow-up. J Orthop. 2020 Aug 28;22:397-401.

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Klaassen A, Schäffer B, Willigenburg N, Van Beers L, Scholtes V, Van Der Hulst V, Koster L, Kaptein B, Moojen D, Poolman RW.

Comparison of early migration patterns between a ceramic and polyethylene liner in uncemented Trabecular Titanium cups: a 2-year randomized controlled trial of 52 hips using radiostereometric analysis. Acta Orthop. 2022 Feb 22; 93: 451–458.

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Klasan A, Bayan A, Holdaway I, Farrington WJ.

Liner type has no impact on bone mineral density changes around a 3D printed trabecular titanium acetabular component. Orthop Traumatol Surg Res. 2023 Feb;109(1):103136.

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Massari L, Bistolfi A, Grillo PP, Borré A, Gigliofiorito G, Pari C, Francescotto A, Tosco P, Deledda D, Ravera L, Causero A.

Periacetabular bone densitometry after total hip arthroplasty with highly porous titanium cups: a 2-year follow-up prospective study. Hip Int. 2017 Nov 21;27(6):551-557.

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