Porous tantalum implant for treatment of early-stage osteonecrosis of the femoral head: a minimum 5-year follow-up study

Abstract

Background To evaluate the survival rate of porous tantalum rod implantation in the treatment of osteonecrosis of the femoral head (ONFH), evaluate its clinical effect and imaging results. Methods From January 2008 to December 2013, porous tantalum rod implantation for ONFH was performed in two institutions. Statistical analysis of operation data, including operation time, blood loss and blood transfusion were recorded. Results 52 hips received complete follow-up, the average follow-up time was 85.7 months (60–132 months). 24 hips turned to THA at the end of follow-up (46.2%), the average time was 44.3 ± 32.8 months, and the average Harris hip score before THA was 57.1 ± 7.6. Cox proportional-hazards model revealed that Association Research Circulation Osseous (ARCO) stage (P = 0.017), bone marrow edema (P = 0.006) and age > 40 years (P = 0.043) were independent risk factors for conversion to THA. Conclusion ARCO stage, age and bone marrow edema were risk factors for the failure of porous tantalum rod implantation to convert to THA.

Reconstructing avascular necrotic femoral head through a bioactive β-TCP system: From design to application

“…In a meta-analysis of 20 studies involving 1323 cases who underwent core decompression, the hip survival rate was 66% during 54.3 months of median follow-up [ 4 ]. The clinical results in our study were also superior to other non-vascularized bone substitute materials, including tantalum rod implantation [ 48 , 49 ], CaSO4–CaPO4 [ 50 ], demineralized bone matrix [ 51 , 52 ], allogeneic bone [ [53] , [54] , [55] ], and so on. In recent years, a variety of artificial materials have been studied for treating ANFH.…”

An all-arthroscopic light bulb technique to treat osteonecrosis of the femoral head through outside-in fashion without distraction: A case report

“…CT mainly focuses on the application of detecting subchondral fractures The pathogenesis of ONFH is not completely clear, but the common characteristic of ONFH is the impaired blood supply of the femoral head (24). Therefore, hip-preserving treatment of ONFH includes several important principles such as debriding the necrotic bone, promoting revascularization and new bone formation, decreasing the intraosseous pressure of the femoral head and improving the venous circulation, providing the mechanical support of the femoral head, and preventing or halting femoral head collapse (25).…”

Preparation, modification, and clinical application of porous tantalum scaffolds

“…Although the long-term efficacy of Ta rods remains controversial, patient survival after the insertion of porous Ta rods is known to be affected by multiple factors such as disease stage, corticosteroid use, volume and location of osteonecrosis lesions, bone marrow edema, and joint effusion (Zhang et al, 2016;Zhang et al, 2021;Liu et al, 2022b). Accordingly, numerous optimized surgical techniques have been applied to improve the osteogenic capacity of porous Ta rods such as the combined technique involving bone marrow extraction from the iliac crest (Emilios et al, 2015), BMSCs, and graft (Pakos et al, 2015;FIGURE 9 Tantalum activates the Wnt/β-catenin signaling pathway, BMP signaling pathway, TGF-β signaling pathway, and integrin signaling pathway by promoting the expression of Wnt, BMP-2, TGF-β, and integrins.…”