Depuy | Pinnacle Acetabular Cup System | Which Medical Device
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Orthopaedics
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Acetabular components - uncemented
From Which Medical Device
The Pinnacle Acetabular Cup System from Depuy comprises a 180 degree titanium shell with coating options including Porocoat (titanium sintered beads) Duofix (Porocoat with an HA coating) and Gription (high friction porous surface). The shell is designed to accept polyethylene, ceramic and metal liners (Marathon or AltrX, Biolox and Ultamet respectively). This flexibility is achieved because the interior of the socket includes a Variable Interface Prosthesis (VIP), which has a central dome for polyethylene contact, and a peripheral taper into which a hard bearing liner can be introduced. Like the Trident socket, the introducer screws into the shell and the resulting hole can be filled with an obturator once the introducer is removed.
The shell comes in four varieties, the “100 cup” which has a hole for the introducer only, the “300” cup which is similar but has three spikes for additional fixation, the 3-hole “Sector” cup, and a Multihole version.
Smaller sizes (38-46mm) are known as the Pinnacle Bantam Acetabular Cup System.
The device has been available since 2002. It was the market leader in the 7th National Joint Registry report of 2010, with 33% of the market in uncemented designs, and a five year revision rate of 2.9% (2.4 to 3.5%). It is most often implanted with the Corail stem. It has an ODEP 7A rating.
One study suggests that the risk of retroacetabular osteolysis has been reduced in this design of shell compared with the earlier Duraloc because of an improved locking mechanism (Powers et al). There is a case report of shearing of the peripheral locking tabs of a Marathon liner (Mesko JW).
An Surgical Technique Guide for the Pinnacle Acetabular Cup can be found here.
References
Powers CC, Ho H, Beykirch SE, Huynh C, Hopper RH Jr, Engh CA Jr, Engh CA. A comparison of a second- and a third-generation modular cup design: is new improved? J Arthroplasty. 2010 Jun;25(4):514-21. Epub 2009 Apr 9.
Mesko JW. Acute liner disassociation of a Pinnacle acetabular component. J Arthroplasty. 2009 Aug;24(5):815-8. Epub 2008 Jun 13
No authors listed. National Joint Registry for England and Wales: 7th Annual Report 2010.
Notes
In January 2012, Depuy stopped selling a number of custom medical devices including the Pinnacle Acetabular Cup System in response to a warning letter from the FDA. Find out more here.
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