Porous tantalum rod in treating early-stage avascular necrosis of the femoral head:Application and issues / 中国组织工程研究

ABSTRACT

BACKGROUND:Each clinical treatment option for avascular necrosis of the femoral head has its own advantages and disadvantages, but early diagnosis and early treatment are firmly rooted in most of orthopedic doctors, and the purpose of treatment is focused on how to preserve the femoral head and how to maintain the hip function. OBJECTIVE:To summarize the current opinions and studies concerning the treatment of avascular necrosis of the femoral head, including core decompression and porous tantalum rod implantation, and to elucidate the clinical results and cost-effectiveness of the use of porous tantalum rod. METHODS:The PubMed database was searched by the first author for the articles on the aspect of pathogenesis, risk factors, disease staging and treatment options of avascular necrosis of the femoral head from January 1985 to August 2013 with the key words of“avascular necrosis”,“osteonecrosis of the femoral head”and “tantalum rod”in titles or abstracts. Literatures exhibiting poor correlation with the research purpose and duplicate literature were excluded, and final y, 42 articles were included in result analysis. RESULTS AND CONCLUSION:The key point of treating avascular necrosis of the femoral head depends on early diagnosis and early intervention. Core decompression plus porous tantalum rod implantation is a minimal y invasive technique in treating early-stage avascular necrosis of the femoral head, in which the subchondral fracture and the femoral head col apse do not occur. If core decompression and porous tantalum rod implantation is used properly, this option does delay or prevent the progress of avascular necrosis of the femoral head. But, if avascular necrosis of the femoral head is in late stage, which means that subchondral fracture and the femoral head col apse occur, the clinical results of this option are poor. Although porous tantalum rod implantation in the treatment of early-stage avascular necrosis of the femoral head demonstrates good exciting short-term results, the clinical value of its long-term results and cost-effectiveness should be elucidated in multicentre, double-blinded, randomized, control ed trials in the future.