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
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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).
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.
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.
Our technique is safety and effective in the treatment of ARCO stage I-II non-traumatic ONFH.
KeywordsReal-time CT accurate positioning Porous tantalum implant Osteonecrosis of the femoral head
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.
- 1.Feng Y, Yang SH, Xiao BJ, Xu WH, Ye SN, Xia T, Zheng D, Liu XZ, Liao YF (2010) Decreased in the number and function of circulation endothelial progenitor cells in patients with avascular necrosis of the femoral head. Bone 46(1):32–40. https://doi.org/10.1016/j.bone.2009.09.001 CrossRefPubMedGoogle Scholar
- 9.Bobyn JD, Poggie RA, Krygier JJ, Lewallen DG, Hanssen AD, Lewis RJ, Unger AS, O'Keefe TJ, Christie MJ, Nasser S, Wood JE, Stulberg SD, Tanzer M (2004) Clinical validation of a structural porous tantalum biomaterial for adult reconstruction. J Bone Joint Surg Am 86-A(Suppl 2):123–129CrossRefGoogle Scholar
- 23.Floerkemeier T, Thorey F, Daentzer D, Lerch M, Klages P, Windhagen H, von Lewinski G (2011) Clinical and radiological outcome of the treatment of osteonecrosis of the femoral head using the osteonecrosis intervention implant. Int Orthop 35(4):489–495. https://doi.org/10.1007/s00264-009-0940-9 CrossRefPubMedGoogle Scholar
- 24.Liu Y, Su X, Zhou S, Wang L, Wang C, Liu S (2015) A modified porous tantalum implant technique for osteonecrosis of the femoral head: survivorship analysis and prognostic factors for radiographic progression and conversion to total hip arthroplasty. Int J Clin Exp Med 8(2):1918–1930PubMedPubMedCentralGoogle Scholar
- 26.Floerkemeier T, Lutz A, Nackenhorst U, Thorey F, Waizy H, Windhagen H, von Lewinski G (2011) Core decompression and osteonecrosis intervention rod in osteonecrosis of the femoral head: clinical outcome and finite element analysis. Int Orthop 35(10):1461–1466. https://doi.org/10.1007/s00264-010-1138-x CrossRefPubMedGoogle Scholar
- 29.Levine BR, Sporer S, Poggie RA, Della Valle CJ, Jacobs JJ (2006) Experimental and clinical performance of porous tantalum in orthopedic surgery. Biomaterials 27(27):4671–4681. https://doi.org/10.1016/j.biomaterials.2006.04.041 CrossRefPubMedGoogle Scholar