Outcome after tantalum rod implantation for treatment of femoral head osteonecrosis

Varitimidis, Sokratis; Dimitroulias, Apostolos; Karachalios, Th.; Dailiana, Zoe; Malizos, Konstantinos N.

doi:10.1080/17453670902804877

Cited by 52 publications

(76 citation statements)

References 34 publications

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“…In the present study, in which weightbearing was not allowed until six weeks after surgery, eight of 52 hips (15.4 [14][15][16][17] and by Varitimidis et al [19], possibly because of the wide excision of femoral head necrotic bone, addition of porous medical composite bone filling material before implantation of the porous tantalum rod [22], and delay of postoperative load bearing. However, potential advantage of earlier load bearing could have a negative influence on treatment outcome.…”

Section: Discussionmentioning

confidence: 97%

“…Post-operatively, patients were instructed to be non-weightbearing for three weeks, partially weightbearing for an additional three weeks, and then to bear weight as tolerated. Varitimidis et al [19] retrospectively studied 26 hips after tantalum rod implantation for treatment of Steinberg stages II-IV ONFH with postoperative partial weightbearing for six weeks. Survivorship was 70 % at a mean 38-month follow-up (range, 15-71 months).…”

Section: Discussionmentioning

confidence: 99%

“…The authors indicated that a porous tantalum rod was a reasonable mechanical substitute for a fibular graft. Since 2005, there have been a number of investigations of treatment of ONFH with core decompression followed by placement of a porous tantalum rod [14][15][16][17][18][19][20][21]. However, clinical outcomes, including post-operative time to weightbearing and the role of the porous tantalum implant, are conflicting [18,21].…”

Section: Introductionmentioning

confidence: 99%

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Tantalum rod implantation for femoral head osteonecrosis: survivorship analysis and determination of prognostic factors for total hip arthroplasty

Liu

Yan

Zhou

et al. 2015

International Orthopaedics (SICOT)

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Compared with the traditional impaction composite bone material technique, implantation of tantalum rod in the treatment of Steinberg stages I and II ONFH can obtain better clinical results and higher cumulative survival rates. For patients without the use of corticosteroids, and especially for hips without bone marrow oedema, the clinical results from our study show highly encouraging survival rates and a delay in or prevention of conversion into THA.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Tantalum rod implantation for femoral head osteonecrosis: survivorship analysis and determination of prognostic factors for total hip arthroplasty

Liu

Yan

Zhou

et al. 2015

International Orthopaedics (SICOT)

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“…Inconsistencies exist in the results of the use of the tantalum rod implant method applied to ONFH [18,31]. No acknowledged surgical technique or relevant studies that can clearly reduce postoperative collapse of the femoral head are available [1].…”

Section: Discussionmentioning

confidence: 99%

“…This treatment is supposed to provide an effective support for subcartilaginous osseous lamellae by reestablishing bone at the weight-bearing site of the femoral head after internal decompression of the femoral head. Tantalum rod implantation is relatively simple, with a small surgical wound [18]. The round medial end of the TMR supports the articular cartilage and subchondral bone, stimulating the repair process and favoring local vascularization [19][20][21][22][23][24].…”

Section: Discussionmentioning

confidence: 99%

Failure of a properly positioned tantalum rod for treatment of early femoral head necrosis and conversion to total hip arthroplasty

Osman

Bassiony

Asal

et al. 2015

Eur Orthop Traumatol

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Background Conventional core decompression (CD) is a well-known procedure for treatment of avascular necrosis of the femoral head. Weight bearing is usually restricted in the early postoperative weeks to avoid the risk of fracture. Theoretically, a properly positioned implantation of the new tantalum rod after reaming of the necrotic area has the advantages of decompression, supports the remaining bone to avoid collapse, lowers the risk of subtrochanteric fracture, and allows for early weight bearing. The objective of this study was to evaluate the role of the tantalum rod in the management of early avascular necrosis. Patients and methods Twenty patients with a mean age of 30.4 years were treated with CD and implantation of a tantalum rod. The cases were evaluated radiologically by x-rays, CT, and MRI. Sixteen cases were idiopathic while four patients were corticosteroid induced. Using the Steinberg classification system, Fifteen hips were stage II and five hips stage III. Postoperative CT was done in all cases to ensure proper position of the cases. Results Clinical and radiographic evaluation was carried out preoperatively then at 3, 12, and 24 months postoperatively. The average preoperative Harris Hip Score (HHS) was 42.5 and improved to 80.7 at 3 months with two cases of persistent pain and unsatisfactory results with conversion to total hip arthroplasty (THA) in the first 6 months. At 1 year, the average HHS was deteriorated to 76.1 of the remaining 18 cases. At 2 years endpoint follow-up, five cases already converted to THA, another seven cases had a deterioration of the HHS score, and only 40 % of the cases had satisfactory results. Conclusion Implantation of a porous tantalum metal rod for early-stage osteonecrosis of the femoral head did not add a significant advantage to core decompression alone even with the proper position in relation to the necrotic area. We had to convert to total hip arthroplasty in 60 % of the cases.

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Bone tissue engineering for treating osteonecrosis of the femoral head

Bian

et al. 2023

Exploration

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Osteonecrosis of the femoral head (ONFH) is a devastating and complicated disease with an unclear etiology. Femoral head-preserving surgeries have been devoted to delaying and hindering the collapse of the femoral head since their introduction in the last century. However, the isolated femoral head-preserving surgeries cannot prevent the natural progression of ONFH, and the combination of autogenous or allogeneic bone grafting often leads to many undesired complications. To tackle this dilemma, bone tissue engineering has been widely developed to compensate for the deficiencies of these surgeries. During the last decades, great progress has been made in ingenious bone tissue engineering for ONFH treatment. Herein, we comprehensively summarize the state-of-the-art progress made in bone tissue engineering for ONFH treatment. The definition, classification, etiology, diagnosis, and current treatments of ONFH are first described. Then, the recent progress in the development of various bone-repairing biomaterials, including bioceramics, natural polymers, synthetic polymers, and metals, for treating ONFH is presented. Thereafter, regenerative therapies for ONFH treatment are also discussed. Finally, we give some personal insights on the current challenges of these therapeutic strategies in the clinic and the future development of bone tissue engineering for ONFH treatment. K E Y WO R D S biomaterials, bone tissue engineering, osteonecrosis of the femoral head, regenerative therapy  Yixin Bian and Tingting Hu contributed equally to this work.

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Outcome after tantalum rod implantation for treatment of femoral head osteonecrosis

Cited by 52 publications

References 34 publications

Tantalum rod implantation for femoral head osteonecrosis: survivorship analysis and determination of prognostic factors for total hip arthroplasty

Tantalum rod implantation for femoral head osteonecrosis: survivorship analysis and determination of prognostic factors for total hip arthroplasty

Failure of a properly positioned tantalum rod for treatment of early femoral head necrosis and conversion to total hip arthroplasty

Bone tissue engineering for treating osteonecrosis of the femoral head

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