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Outcome after tantalum rod implantation for treatment of femoral head osteonecrosis: 26 hips followed for an average of 3 years.

Varitimidis SE, Dimitroulias AP, Karachalios TS, Dailiana ZH, Malizos KN - Acta Orthop (2009)

Bottom Line: The disease process does not appear to be interrupted,but there was a significant improvement in hip function initially in most hips.Tantalum rod implantation is a safe "buy-time" technique, especially when other joint salvage procedures are not an option.Appropriate patient selection and careful rod insertion are needed for favorable results.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedic Surgery, School of Medicine, University of Thessalia, Larissa, Greece.

ABSTRACT

Background and purpose: Tantalum rod implantation has recently been proposed for treatment of early stages of femoral head osteonecrosis.The purpose of our study was to report the early results of its use in pre- and post-collapse stages of the disease.

Methods: We studied prospectively 27 patients who underwent tantalum rod implantation for treatment of nontraumatic femoral head osteonecrosis between December 2000 and September 2005. Patients were evaluated radiologically and clinically using the Steinberg classification and the Harris hip score (HHS). Disease stage varied between stages II and IV. Mean follow-up time was 38 (15-71) months.

Results: 1 patient (1 hip) died 15 months after surgery for reasons unrelated to it. 13 of 26 hips remained at the same radiographic stage, and 13 deteriorated. Mean HHS improved from 49 to 85. 6 patients required conversion to total hip arthroplasty. When the procedure was used for stages III and IV, both radiological outcome and revision rates were worse than for the stage II hips. There was, however, no difference in postoperative HHS between patients at pre- and post-collapse stages at the time of initial evaluation. Survivorship, with revision to THA as the endpoint,was 70% at 6 years.

Interpretation: The disease process does not appear to be interrupted,but there was a significant improvement in hip function initially in most hips. Tantalum rod implantation is a safe "buy-time" technique, especially when other joint salvage procedures are not an option. Appropriate patient selection and careful rod insertion are needed for favorable results.

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Related in: MedlinePlus

Kaplan-Meier survivorship curve with 95% pointwise confidence intervals using total hip arthroplasty as the endpoint. Vertical marks indicate censored data.
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Figure 0001: Kaplan-Meier survivorship curve with 95% pointwise confidence intervals using total hip arthroplasty as the endpoint. Vertical marks indicate censored data.


Outcome after tantalum rod implantation for treatment of femoral head osteonecrosis: 26 hips followed for an average of 3 years.

Varitimidis SE, Dimitroulias AP, Karachalios TS, Dailiana ZH, Malizos KN - Acta Orthop (2009)

Kaplan-Meier survivorship curve with 95% pointwise confidence intervals using total hip arthroplasty as the endpoint. Vertical marks indicate censored data.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2823224&req=5

Figure 0001: Kaplan-Meier survivorship curve with 95% pointwise confidence intervals using total hip arthroplasty as the endpoint. Vertical marks indicate censored data.
Bottom Line: The disease process does not appear to be interrupted,but there was a significant improvement in hip function initially in most hips.Tantalum rod implantation is a safe "buy-time" technique, especially when other joint salvage procedures are not an option.Appropriate patient selection and careful rod insertion are needed for favorable results.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedic Surgery, School of Medicine, University of Thessalia, Larissa, Greece.

ABSTRACT

Background and purpose: Tantalum rod implantation has recently been proposed for treatment of early stages of femoral head osteonecrosis.The purpose of our study was to report the early results of its use in pre- and post-collapse stages of the disease.

Methods: We studied prospectively 27 patients who underwent tantalum rod implantation for treatment of nontraumatic femoral head osteonecrosis between December 2000 and September 2005. Patients were evaluated radiologically and clinically using the Steinberg classification and the Harris hip score (HHS). Disease stage varied between stages II and IV. Mean follow-up time was 38 (15-71) months.

Results: 1 patient (1 hip) died 15 months after surgery for reasons unrelated to it. 13 of 26 hips remained at the same radiographic stage, and 13 deteriorated. Mean HHS improved from 49 to 85. 6 patients required conversion to total hip arthroplasty. When the procedure was used for stages III and IV, both radiological outcome and revision rates were worse than for the stage II hips. There was, however, no difference in postoperative HHS between patients at pre- and post-collapse stages at the time of initial evaluation. Survivorship, with revision to THA as the endpoint,was 70% at 6 years.

Interpretation: The disease process does not appear to be interrupted,but there was a significant improvement in hip function initially in most hips. Tantalum rod implantation is a safe "buy-time" technique, especially when other joint salvage procedures are not an option. Appropriate patient selection and careful rod insertion are needed for favorable results.

Show MeSH
Related in: MedlinePlus