ABSTRACT
Objective To discuss the efficacy of tantalum rod implantation combined with bone transplantation in the treatment of early stage osteonecrosis of the femoral head.Methods Twenty-four male patients were re cruited.Twelve patients were allocated to the tantalum rod and bone implantation group.The mean age was 35.7 years.Twelve patients were allocated to the tantalum rod implantation group.The mean age was 33.2 years.All patients with stage Ⅱ osteonecrosis.Results All patients were followed up with an average of 42.5 ± 6.7 months.The final evaluation was made according to the last follow-up data.In the tantalum rod implantation group,the average score of pre-operation and post-operation were 65.3±6.3,82.6 ± 5.3 respectively with a statistic difference (P ＜ 0.05).Two of patients underwent total hip replacement before the end of this study,significant difference was observed in the aspect of radiographic progression (P ＜ 0.05).In the tantalum rod implantation combined with bone marrow stem cell transplantation group,the average score was 92.2 ± 1.0 with a statistic difference (P ＜ 0.05).There was no one of patients underwent total hip replacement before the end of this study.Significant difference was observed in the aspect of radiographic progression (P ＜ 0.05).Between the two groups,a significant difference was observed in clin ical symptoms in favor of the tantalum rod implantation combined with bone transplantation group(P ＜ 0.05).No significant difference was observed in the aspect of radiographic progression (P ＞ 0.05).Significant difference was observed in the aspect of survivorship of the femoral head(P ＜ 0.05).Conclusion Tantalum rod implantation combined with bone transplantation improves clinical symptoms and delay total hip arthoplasty than tantalum rod implantation.
ABSTRACT
Objective To investigate the effects of Porous tantalum rod implantation and autologous peripheral blood stem cell transplantation on the treatment of avascular necrosis of femoral head (ANFH).Methods Thirty-six cases with early ANFH (19 cases on the left side and 17 cases on the right side) treated by Porous tantalum rod implantation and matrix induced autologous peripheral blood stem cell trans-plantation from July 2009 to March 2011.The 36 cases had osteonecrosis of the femoral head(ONFH) lesions Ⅰ and Ⅱ according to the international bone circulation Research Association (ARCO) classification of ONFH lesion.All patients were followed up for 12-15 months.Clinical evaluation included preoperative and postoperative pain score,the Harris hip score,percentage of low signal MRI area in the volume of femoral head.Results All the patients were followed up for 12 to 15 months.The postoperative Harris hip score was significantly higher than pre-operation ((91.70 ± 6.90) vs.(68.32 ± 7.10) ; t =4.364,P ＜ 0.01).Pain symptoms reduced markedly ((15.55 ±6.60) vs.(29.78 ±5.67);t =3.423,P ＜0.05).Hip flexion and external rotation function was restored.MRI showed that after the operations the volume of areas with femoral head necrosis significantly reduced in compared with the pre-operation ((38.20 ± 8.30) ％ vs.(21.43 ± 5.10) ％ ; t =6.527,P ＜ 0.05).Conclusion Porous tantalum rod implantation and autologous peripheral blood stem cell transplantation can significantly reduce joint pain,dramatically restore joint function,effectively prevent collapse of the femoral head,retard progression and has good clinical efficacy in the treatment of early femoral head necrosis.
ABSTRACT
Objective To investigate the effeit of Reconstruction of tantalum metal rod implantation in the treatment of early ischemic necrosis of femoral head( Steinberg Ⅰ～Ⅱ period) ,to explore the early femoral head ischemic necrosis of minimally invasive treatme(n)t. Method 24 patients( Steinberg Ⅰ～Ⅱ period) using C-arm fluoroscopy machine,under the greater trochanter through the neck hole to avascular necrosis zone,the first zone of the medullary sclerosis core decompression, re-implantation of tantalum rod to the subchondral bone is about 0.5 cm, through the Harris score before and after surgery for comparison. Results After follow-up 9(2 ～ 12) months,preoperative pain and function were significantly limited nuitigation. The excellent rate was 83% after opertion. MRI manifestations in patients with stable,non-ischemic necrosis increased performance. Conclusion Core decompression can significantly reduce the pressure on the femoral head hardening region, tantalum rod weight-bearing area of femoral head implant provides a structural support for subchondral bone. This method has the characteristics decompression,structural support,minimally invasive,it is worth for clinical use.