Total hip arthroplasty following failure of tantalum rod implantation for osteonecrosis of the femoral head with 5- to 10-year follow-up

Cheng, Qi; Tang, Jinlong; Gu, Jiangjiang; Guo, Kaijin; Guo, Wang-shou; Wang, Bailiang; Zhao, Fengchao

doi:10.1186/s12891-018-2219-z

Cited by 19 publications

(17 citation statements)

References 34 publications

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“…Extracting a rod is technically demanding due to strong osseointegration of the porous tantalum rod (10). Challenges inclu0de increased blood loss, longer operative time, bone loss along the trajectory of the rod and the subsequent potential increased risk of femoral fracture (44,45). For this reason, additional data and further prospective studies are required to support the conclusion that tantalum rod implantation is more effective than bone transplant or core decompression and to assess the risks, benefits and financial issues for patients.…”

Section: Discussionmentioning

confidence: 99%

Comparison of core decompression and porous tantalum rod implantation with conservative treatment for avascular necrosis of the femoral head: A minimum 18�month follow‑up study

et al. 2020

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Porous tantalum rod implantation is a novel surgical method that is used to treat avascular necrosis (AVN) of the femoral head (hip). In the present study, the results of core decompression and tantalum rod implantation were compared with non-surgical treatment for AVN, and the survivorship of the femoral head was evaluated. In total, 60 patients with AVN femoral head were recruited and analysed. Non-surgical treatment was selected by 30 patients (41 hips), 7 with a Ficat score of I and 23 with a score of II. Non-surgical treatment included celecoxib, salvia miltiorrhiza and tetramethylypyrazine and a reduction in weight-bearing activities. Surgical treatment and porous tantalum rod implantation were selected by 30 patients (41 hips), 10 with a Ficat score of I and 20 with a score of II. After follow-up (average: 33.5 months), patients were evaluated by assessing post-operative complications, radiology, hip survivorship and Harris hip score. In the surgical group, pre-operative symptoms were significantly alleviated. No complications, including infection, delayed healing or fractures were reported. Final follow-up rates of femoral head survivorship were 4.9% in the non-surgical group and 36.7% in the surgical group. The Harris hip score was significantly improved following surgery when compared with non-surgical treatment (P<0.05). The results indicated that core decompression and porous tantalum rod implantation are beneficial short-and mid-term treatment methods for AVN of the femoral head.

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Section: Discussionmentioning

confidence: 99%

Comparison of core decompression and porous tantalum rod implantation with conservative treatment for avascular necrosis of the femoral head: A minimum 18�month follow‑up study

et al. 2020

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“…First, it is difficult to completely remove necrotic bone. Actually the necrotic subchondral bone is hard to heal with bone graft, marked collapsed is still observed during conversion to THA [18,[27][28][29][30][31] . Second, we could not perform perfect bone grafting to fill the canal.…”

Section: Discussionmentioning

confidence: 99%

“…However, none of these treatment modalities have been found to be universally successful. The reasons for the failure of these treatments are that dead bone cannot be replaced by viable bone, subchondral bone does not have sufficient mechanical support, and subsequent progression of osteoarthritis [27][28][29][30][31] .…”

Section: Introductionmentioning

confidence: 99%

Modified trapdoor procedures using autogenous tricortical iliac graft without preserving the broken cartilage to treat osteonecrosis of the femoral head: A Prospective Cohort Study With Historical Controls

Cheng

zhao

et al. 2020

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Background The aim of the present study was to investigate clinical and radiological outcomes of autologous tricortical iliac graft through a window created at the femoral head, without suturing the opened articular cartilage to treat osteonecrosis of the femoral head (ONFH), called modified trapdoor procedures.Methods A total of 59 consecutive patients (67 hips; 36 males and 23 females) with ONFH were included in this study, which was conducted during the period from April 2009 to March 2012. Patient age ranged from 27 to 46 years old, with mean age of 36.3 years. Harris hip scores (HHS) were used to evaluate hip function pre- and postoperatively. Anteroposterior and frog-position X-rays and magnetic resonance imaging (MRI) were conducted to evaluate lesion location, size, and ARCO stage. Clinical failure was defined as score < 80 points or treatment by total hip arthroplasty(THA). Radiographic failure was defined as a > 3 mm of collapse in the hip. This group was retrospectively matched according to the ARCO stage, extent, location, etiology of the lesion, average age, gender, and preoperative Harris hip score to a group of 59 patients (67 hips) who underwent the“light bulb”approach during March 2007 to April 2009. Results Mean follow-up was 91.2 ± 13.6 months (range, 75–115 months). Mean HHS was 91.3 ± 4.5, compared with 83.1± 4.5 in the “light bulb” cohort at the 6 years follow-up examination (P < 0.001). At the 6 years follow-up, for modified trapdoor procedures, five hips (8.5%) were classified as clinical failure, and 3 hips underwent total hip arthroplasty; Seven hips were classified as (10.4%) radiographic failure.The clinical and radiographic failure of the hips treated with the modified trapdoor procedure was significantly lower than that of the hips treated with the “light bulb” procedure (p < 0.05). Survival of the joint was not significantly related to the location of the femoral head lesion between two groups, but there was better clinical and radiographic results in modified trapdoor procedures with Size-C and the ARCO stage III.Conclusion The study demonstrated superior medterm clinical results in ONFH with the use of autologous tricortical iliac block graft through a femoral head window, without suturing the opened articular cartilage. The results of this femoral head-preserving procedure in patients with postcollapse osteonecrosis and large lesion are superior to those of the “light bulb” procedure treatment.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Modified trapdoor procedures using autogenous tricortical iliac graft without preserving the broken cartilage to treat osteonecrosis of the femoral head: A Prospective Cohort Study With Historical Controls

Cheng

zhao

et al. 2019

Preprint

Self Cite

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Background The aim of the present study was to investigate clinical and radiological outcomes of autologous tricortical iliac graft through a window created at the femoral head, without suturing the opened articular cartilage to treat osteonecrosis of the femoral head (ONFH), called modified trapdoor procedures. Methods A total of 59 consecutive patients (67 hips ) with ONFH were included in this study, which was conducted during the period from April 2009 to March 2012. Harris hip scores (HHS) were used to evaluate hip function pre- and postoperatively. Anteroposterior and frog-position X-rays and magnetic resonance imaging (MRI) were conducted to evaluate lesion location, size, and ARCO stage. Clinical failure was defined as score < 80 points or treatment by total hip arthroplasty(THA). Radiographic failure was defined as a > 3 mm of collapse in the hip. This group was retrospectively matched according to the ARCO stage, extent, location, etiology of the lesion, average age, gender, and preoperative Harris hip score to a group of 59 patients (67 hips) who underwent the“light bulb”approach during March 2007 to April 2009. Results Mean follow-up was 91.2 ± 13.6 months (range, 75–115 months). Mean HHS was 91.3 ± 4.5, compared with 83.1± 4.5 in the “light bulb” cohort at the 6 years follow-up examination ( P < 0.001). At the 6 years follow-up, for modified trapdoor procedures, five hips (8.5%) were classified as clinical failure, and 3 hips underwent total hip arthroplasty; Seven hips were classified as (10.4%) radiographic failure.The clinical and radiographic failure of the hips treated with the modified trapdoor procedure was significantly lower than that of the hips treated with the “light bulb” procedure (p < 0.05). Survival of the joint was not significantly related to the location of the femoral head lesion between two groups, but there was better clinical and radiographic results in modified trapdoor procedures with Size-C and the ARCO stage III. Conclusion The study demonstrated superior medterm clinical results in ONFH with the use of autologous tricortical iliac block graft through a femoral head window, without suturing the opened articular cartilage.

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Total hip arthroplasty following failure of tantalum rod implantation for osteonecrosis of the femoral head with 5- to 10-year follow-up

Cited by 19 publications

References 34 publications

Comparison of core decompression and porous tantalum rod implantation with conservative treatment for avascular necrosis of the femoral head: A minimum 18�month follow‑up study

Comparison of core decompression and porous tantalum rod implantation with conservative treatment for avascular necrosis of the femoral head: A minimum 18�month follow‑up study

Modified trapdoor procedures using autogenous tricortical iliac graft without preserving the broken cartilage to treat osteonecrosis of the femoral head: A Prospective Cohort Study With Historical Controls

Modified trapdoor procedures using autogenous tricortical iliac graft without preserving the broken cartilage to treat osteonecrosis of the femoral head: A Prospective Cohort Study With Historical Controls

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