Effect of a porous tantalum rod on early and intermediate stages of necrosis of the femoral head

Abstract

The aim of this study was to evaluate the effect of a porous tantalum rod implant for the treatment of early femoral head necrosis. From April 2007 to June 2009, a total of 35 femoral head necrosis patients (with 49 hips) were treated with core decompression in combination with the insertion of a porous tantalum rod. The mean age was 38.2 years (22-50 years) and the mean follow-up period was 15.2 months (12-36 months). The surgical time and blood loss were recorded. The Harris hip scores and radiological results were adopted for evaluation. The mean surgical time was 35 min, and the mean blood loss was 50 ml. The mean Harris score improved from 48.3 ± 3.2 preoperative to 83.7 ± 4.1 at the last follow-up (p < 0.05). Eight affected hips exhibited progressive pain including three hips that progressed to femoral collapse, and one revision followed by total hip arthroplasty (THA). For the patient who underwent revision and THA, the articular cartilage surface was seen to be damaged and fragmented. High-density metal particle residuals were observed on radiograph in the bone channel and femoral marrow cavity. We conclude that the selection criteria for porous tantalum implants should be early and intermediate stages of femoral head necrosis. Further study is warranted to reveal whether the metal particles released play a role in the progression of pain and failure.

A current review of core decompression in the treatment of osteonecrosis of the femoral head

“…There have been attempts to use various adjunctive therapies with this procedure such as the following: (1) bone grafting [13,23,26]; (2) addition of mesenchymal cells [13,23,26]; and (3) tantalum rod insertion [9,11,[36][37][38][39][40][41].…”

“…Core decompression with the insertion of a porous tantalum rod initially showed some positive results [7,37,40]. However, many of these studies were done on very small cohorts, and the removal of these implants has led to complications such as fracture [7,37,40,[51][52][53][54][55].…”

“…However, many of these studies were done on very small cohorts, and the removal of these implants has led to complications such as fracture [7,37,40,[51][52][53][54][55]. Therefore, we do not recommend this as an adjunctive procedure.…”

Preparation of a novel composite nanofiber gel-encapsulated human placental extract through layer-by-layer self-assembly

“…The topical application of active growth factors can promote the healing of chronic ulcer (27); however, our previous study revealed that the exogenous growth factors were easily degraded and diluted due to their short half-life (28). Signaling pathways that are able to awaken the body's self-healing mechanisms are therefore required to promote the sustained release of endogenous growth factors.…”

Osteonecrosis of the femoral head: An update in year 2012

“…Other grafting techniques, such as bone graft pedicled with quadratus femoris in a titanium mesh, have also been developed, but long-term effectiveness has not yet been studied [86] . Augmentation of core decompression with porous tantalum rods has also been explored as a treatment method for early stages of osteonecrosis, with some favorable results; however, the release of high-density metal particles as well as progression to femoral head collapse are frequent complications [87] . Other clinical trials involving the use of trabecular metal rods [88] and mesh cages [86] have also been published.…”