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International Orthopaedics

, Volume 42, Issue 7, pp 1535–1544 | Cite as

Real-time computerised tomography assisted porous tantalum implant in ARCO stage I-II non-traumatic osteonecrosis of the femoral head: minimum five-year follow up

  • Ruyin Hu
  • Pengfei Lei
  • Bo Li
  • Hao Liu
  • Xucheng Yang
  • Ting Wen
  • Yihe Hu
  • Xiaobin Tian
Original Paper

Abstract

Purposes

This study was established to investigate the medium-term clinical effect of real-time CT assisted porous tantalum implant for the treatment of ARCO stage I-II non-traumatic osteonecrosis of the femoral head (ONFH).

Methods

This study comprised 24 ONFH patients (29 hips) who were treated with intra-operative real-time CT accurate rapid positioning assisted drilling decompression, lesion removal and porous tantalum implant. Harris score, VAS score and imaging in pre-operation and follow-up period were recorded.

Results

The average operative time and intra-operative blood loss were 72.6 min and 158.8 ml, respectively. The mean follow-up was 5.4 years. No femoral head penetrating, wound infection, and death occurred. Harris and VAS score improved significantly (73.78 vs. 88.11; 7.13 vs. 2.66) at last follow-up (P < 0.05). The functional improvement and pain relief rate was 100% at six months after operation. The effective rate was 86.21% at 12 months after operation and last follow-up. Five pre-operative ARCO stage I hips had no radiographic progress. Meanwhile, four among the 24 ARCO stage II hips progressed into stage III between eight and 12 months after surgery, among which two progressed into stage IV and two remained in stage III at the last follow-up. The average value of Kerboul combined necrotic angle was 263.24°. There was no progress in Kerboul combined necrotic angle among the grades 2 and 3 patients. However, among the six cases at grade 4, four cases with post-operative progress, two patients converted to THA.

Conclusions

Our technique is safety and effective in the treatment of ARCO stage I-II non-traumatic ONFH.

Keywords

Real-time CT accurate positioning Porous tantalum implant Osteonecrosis of the femoral head 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical review committee statement

This study was approved by the ethic committee of Xiangya Hospital Central South University and followed the Declaration of Helsinki. Informed consent were received from all patients.

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Copyright information

© SICOT aisbl 2018

Authors and Affiliations

  1. 1.Department of OrthopeadicsPeople’s Hospital of Guizhou ProvinceGuiyangPeople’s Republic of China
  2. 2.Department of OrthopeadicsXiangya Hospital Central South UniversityChangshaPeople’s Republic of China
  3. 3.Department of SurgeryUniversity of PittsburghPittsburghUSA

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