Biomechanical and Clinical Evaluations of a Porous Tantalum Implant for the Treatment of Early-Stage Osteonecrosis

Tsao, Audrey K.; Roberson, James R.; Christie, Michael J.; Dore, D.D.; Heck, David A.; Robertson, Douglas D.; Poggie, Robert A.

doi:10.2106/jbjs.e.00490

Cited by 97 publications

(60 citation statements)

References 9 publications

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“…The results of our study differ from the mainly encouraging outcome described by Veillette et al, Tsao et al and Shuler et al [12,15,16]. A possible reason may be the variation of postoperative load bearing.…”

Section: Discussioncontrasting

confidence: 99%

“…They concluded that implantation of this tantalum rod represents an encouraging treatment, especially in patients without chronic systemic disease. Shuler et al presented a survival rate of 86% after 39 months after insertion of the tantalum implant and six weeks protected weight bearing [12], while Tsao et al described a survival rate of 85% at 12 months, 79% at 24 months and 73% at 48 months [15]. In the multicentre study of Tsao et al, information about the postoperative procedure is not included.…”

Section: Discussionmentioning

confidence: 99%

“…The study was approved by the local ethics committee. Detailed biomechanical characteristics of this implant have been described previously [1,2,15]. The operations were performed between December 2003 and March 2007.…”

Section: Inclusion Criteriamentioning

confidence: 99%

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Clinical and radiological outcome of the treatment of osteonecrosis of the femoral head using the osteonecrosis intervention implant

Floerkemeier

Thorey

Daentzer

et al. 2010

International Orthopaedics (SICOT)

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The aim of this study was to evaluate the clinical and radiological outcome of the treatment of osteonecrosis of the femoral head by implantation of an osteonecrosis intervention rod. In this retrospective study the follow-up of 19 patients with 23 osteonecrotic femoral heads treated with implantation of an osteonecrosis intervention implant was assessed. From 19 patients with 23 necrotic femoral heads, there were 13 cases in which a total hip replacement was necessary. This implies a survival rate of 44% after implantation of an osteonecrosis intervention rod after a mean follow-up of 1.45 years. The outcome after core decompression combined with the insertion of a tantalum osteonecrosis intervention implant did not show superior results compared to core decompression alone. This is in contrast to existing studies. In addition, this study showed that in cases of total hip replacement, no problems appeared during explantation of the tantalum rod.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Clinical and radiological outcome of the treatment of osteonecrosis of the femoral head using the osteonecrosis intervention implant

Floerkemeier

Thorey

Daentzer

et al. 2010

International Orthopaedics (SICOT)

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“…Autologous bone marrow cell transplantation may be reliable for the treatment of the precollapse stage of ONFH [4][5][6]. Implantation of cylindrical metal (porous tantalum) rods into the femoral head can prevent collapse by providing structural support in the necrotic area, which has been approved as an early-stage therapy [21,22]. However, we believe that direct administration of rhFGF-2-impregnated gelatin hydrogel offers the important advantages of not only being a minimally invasive percutaneous technique that facilitates early return to society but also being able to promote bone regeneration in necrotic areas.…”

Section: Discussionmentioning

confidence: 99%

A pilot study of regenerative therapy using controlled release of recombinant human fibroblast growth factor for patients with pre-collapse osteonecrosis of the femoral head

Kuroda

Asada

et al. 2015

International Orthopaedics (SICOT)

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Purpose We evaluated the safety and clinical outcomes of a single local administration of gelatin hydrogel impregnated with recombinant human fibroblast growth factor (rhFGF)-2 for the treatment of the precollapse stage of osteonecrosis of the femoral head (ONFH). Methods Patients with ONFH (precollapse stage ≤2) received a single local administration of 800 μg of rhFGF-2-impregnated gelatin hydrogel and were followed up for one year. The surgery was performed using a minimally invasive technique involving a 1-cm skin incision, and walking was allowed from day one postoperatively. The primary outcomes included occurrence of adverse events and complications. The secondary outcomes included changes in the Harris hip scores, visual analog scale for pain scores, University of California, Los Angeles (UCLA) activity scores, and radiological images. Results We included ten patients, of which five experienced 14 adverse events, including one complication from spinal anesthesia. However, patients completely recovered from all adverse events. The mean clinical scores significantly improved by one year postoperatively compared with the pre-operative scores (before vs. after: visual analog score for pain, 21.2 vs. 5.3 mm; UCLA activity score, 5.5 vs. 6.6; Harris hip score, 81.0 vs. 96.9 points). There was only one case of femoral head collapse; however, this occurred in a hip with extensive necrosis. Stage progression and collapse did not occur in the other nine cases. Computed tomography confirmed bone regeneration in the femoral heads. Conclusions Clinical application of rhFGF-2-impregnated gelatin hydrogel for patients with precollapse ONFH was feasible and safe.

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“…A diffuse oedema pattern on MRI may be seen in both entities, but a more patchy pattern and the absence of focal defects and subchondral changes is suggestive of TOH (EC ''medium'') [55-69]. • There is no scientific evidence for efficacy of Tantalum-implants and the avascular necrosis rod, which are not recommended (LoE 2?, ER B, EC ''strong'') [148,149] Total hip replacement: outcome and implant fixation…”

Section: Diagnostic Challenges/differential Diagnosesmentioning

confidence: 99%

S3-Guideline non-traumatic adult femoral head necrosis

Röth

Beckmann

Bohndorf

et al. 2015

Arch Orthop Trauma Surg

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Biomechanical and Clinical Evaluations of a Porous Tantalum Implant for the Treatment of Early-Stage Osteonecrosis

Cited by 97 publications

References 9 publications

Clinical and radiological outcome of the treatment of osteonecrosis of the femoral head using the osteonecrosis intervention implant

Clinical and radiological outcome of the treatment of osteonecrosis of the femoral head using the osteonecrosis intervention implant

A pilot study of regenerative therapy using controlled release of recombinant human fibroblast growth factor for patients with pre-collapse osteonecrosis of the femoral head

S3-Guideline non-traumatic adult femoral head necrosis

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