RETRACTED ARTICLE: High failure rate after Beta-tricalcium phosphate grafting for the treatment of femoral head osteonecrosis: a retrospective analysis

Abstract

Background: Non-vascularized bone grafting is a promising head-preserving technique for younger patients diagnosed as non-traumatic osteonecrosis of the femoral head (NONFH). Among the various types of bone grafting techniques, "light-bulb" procedure grafting with synthetic bone substitute is an attractive option. We aimed to assess the effectiveness of using beta-tricalcium phosphate (β-TCP) for the treatment of pre-collapse and early postcollapse lesions NONFH. Methods: From April 2010 to June 2014, 33 patients (47 hips) with NONFH were treated using the afore-mentioned technique. The clinical and radiological outcomes were recorded and compared statistically between pre-and postoperation. Harris hip score (HHS) was used to evaluate the clinical results, and Association Research Circulation Osseous (ARCO) stage was applied to assess the radiological outcomes. Results: The 5-years survival rate of using β-TCP grafting was accounting for 25.5%. HHS was decreased from 78.47 to 52.87 points, and a very significant worsening of radiological results were revealed (P < 0.05). Two hips collapsed more than 2 mm were awaiting for THA, and 33 of the 47 hips had converted to THAs in an average time to failure of 24.24 months postoperatively. Meanwhile, only 4 hips survived without collapse, and 8 hips collapsed less than 2 mm. After surgery, the time onset of head collapse was 3.65 months on average, and the first conversion to THA was performed at 5 months postoperative. Conclusions: Our results suggest that "light-bulb" procedure grafting with β-TCP sticks presented with a high failure rate in the early postoperative period. It is not proposed for the treatment of pre-collapse and early postcollapse lesions NONFH.

Percutaneous autologous impaction bone graft for advanced femoral head osteonecrosis: a retrospective observational study of unsatisfactory short-term outcomes

“…Distinguishing the preoperative stage with or without femoral head collapse, Table 3 compares the results of this study to other surgical methods. The joint preservation rates of different CD-based surgical treatment options range from 13.0 to 92.8% in postcollapse ONFH [ 18 – 24 ]. The short-term results of this study do not compare favorably with other treatments.…”

“…Surgery with only artificial bone grafting has poor outcomes. Liu et al [ 24 ] implanted beta-tricalcium phosphate (β-TCP) in 23 advanced ONFH patients, of whom 20 (87%) were converted to THA at 5 years postoperatively. Allograft might still be better than artificial bone for ONFH, although its efficacy should be tested.…”