Dr. Guido Grappiolo was the first surgeon to use Trabecular Titanium. TT is a revolutionary material and we celebrated its 10th year anniversary in 2017.

" Trabecular Titanium technology is a particularly interesting technology which stimulated my curiosity and my wish on how to improve, especially with regard to the bone prosthesis interaction. Titanium is a highly studied material with many potentials, that I certainly saw in the Trabecular Titanium technology a fact that turned out to be such.

It’s a very long story, because we had historical relationship with an Italian company, Lima, who is the first one who discovered this technology in orthopedics.

So, they came up with this new technology and together we worked out a project, an idea, and using this technology the most natural thought was to apply it to acetabular components.

It’s a well-known technology. The novelty is that Arcam, which is an industry leader in 3D Printing, starting from titanium powders, was able to use this material, titanium, which is so important in prosthesis; so the synergy between Arcam - a leader in industry - and a prosthetic company like Lima developed the project we are talking about producing the first cup that is built with this technology.

Naturally, all this theoretical assumptions had to be proven in vivo and hence it was implanted the first cup produced with the use of this technology to evaluate directly from the clinical outcomes: coherence of the press-fit during the cup positioning; the initial scratch fit and then the long-term follow up.

Now we are at a distance of 10 years and we can say that the project, let’s say the research phase - has brought an excellent result. The follow up is basically what would have given us signals on the performance of this cup and of course in the short-term only the radiographic images could give a clear idea of the osseointegration. We had the chance to use a high definition CT scan system to see just a few months after surgery as in these first patients there was already a direct contact of the bone interconnecting with the service.

Thanks to the quality of the porous material, stability can be reliable in the cases subject in complete bone coverage. This predictable result will in the future lead to this technology being used for many other joints. A particularly interesting area in which the three-dimensional modeling and the micro surface level design will be of great value will be revision surgery.

From a technical point of view, we immediately got a good feeling of stability during the first implant. The patient was a standard patient but with very advanced arthrosis already treated ten years earlier with a conventional cup fixed with screws.

The DELTA-TT cups have proved to be very useful on a daily basis because, as I was saying, an extreme situation such as dysplasia we have made fairly extensive use and we continue to do so. I have personally implanted almost 600 of these cups and my group over 1500 or 1600, so it is definitely one of the cups that best suits some particular demands where it is necessary a particular grip, fixation and or safety is required.

Ten years out from the first case we see that the first patient is doing well. She also has a combination with ceramic which lets us presume that this device could also last for a lifetime so: what’s important in evaluating this first medium-term follow up period?

There is something that works, and so this technology implemented by LimaCorporate with outcome technology - magic powders that has been converted into a three-dimensional structure - is becoming more and more popular.

There is a large spread. Many companies in the orthopedic industry have a strong interest in this technology. "