Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
International Orthopaedics
Published in: International Orthopaedics 7/2018

01-07-2018 | Original Paper

What is the rate of patients undergoing a total hip arthroplasty after core decompression and insertion of a tantalum rod in osteonecrosis of the femoral head: a systematic review

Authors: Jean-Charles Aurégan, Benoît Villain, Thierry Bégué

Published in: International Orthopaedics | Issue 7/2018

Login to get access

Abstract

Purpose

Core decompression (CD) may be effective when performed during the early stages of osteonecrosis of the femoral head (ONFH). Tantalum may be added as a rod that would allow putting some mechanical constraints on the femoral head. We aimed to estimate the rate of total hip arthroplasty after CD and insertion of a tantalum rod during early stages of OFNH.

Methods

We searched systematically Medline via PubMed and the Cochrane Library. Our primary endpoint was the rate of patients undergoing a total hip arthroplasty after CD and insertion of a tantalum rod. Secondary endpoints were the delay between the initial surgery and the arthroplasty, the functional improvement, and the rate of complications.

Results

We included seven  studies reporting the results of 232 patients (297 hips) that were operated on by CD and insertion of a tantalum rod. At a mean follow-up of 26.97 months, 24.63% of the included hips underwent a hip arthroplasty (6–56%, SD = 17.34%). The mean delay between the initial surgery and the arthroplasty was 14.94 months (10.20–22.90; SD = 5.25), the mean improvement of Harris Hip Score was 27.66 (20.20–36.90; SD = 6.48), and the mean rate of femoral fracture was 2.43% (0–13%, SD = 4.89%).

Conclusion

CD and insertion of a tantalum rod may represent a solution in order to improve the mechanical support and to give a rate of conversion in arthroplasty that is acceptable.
Literature
1.
Aldridge JM, Urbaniak JR (2004) Avascular necrosis of the femoral head: etiology, pathophysiology, classification, and current treatment guidelines. Am J Orthop (Belle Mead NJ) 33:327–332
2.
Mont MA, Carbone JJ, Fairbank AC (1996) Core decompression versus nonoperative management for osteonecrosis of the hip. Clin Orthop Relat Res 324:169–178CrossRef
3.
Ficat RP (1985) Idiopathic bone necrosis of the femoral head. Early diagnosis and treatment. J Bone Joint Surg Br 67:3–9CrossRefPubMed
4.
Camp JF, Colwell CW (1986) Core decompression of the femoral head for osteonecrosis. J Bone Joint Surg 68A:1313CrossRef
5.
Smith SW, Fehring TK, Griffin WL, Beaver WB (1995) Core decompression of the osteonecrotic femoral head. J Bone Joint Surg 77A:674CrossRef
6.
Hungerford MW, Mont MA (2000) Potential uses of cytokines and growth factors in treatment of osteonecrosis. Orthopade 29:442–448PubMed
7.
Mont MA, Jones LC, Seyler TM, Marulanda GA, Saleh KJ, Delanois RE (2007) New treatment approaches for osteonecrosis of the femoral head: an overview. Instr Course Lect 56:197–212PubMed
8.
Mont MA, Marulanda GA, Seyler TM, Plate JF, Delanois RE (2000) Core decompression and nonvascularized bone grafting for the treatment of early stage osteonecrosis of the femoral head. Instr Course Lect 56:213–220
9.
Pedersen DR, Brown TD, Poggie RA (1997) Finite element characterization of a porous tantalum material for treatment of avascular necrosis. Trans Orthop Res Soc 22:598
10.
Zhang Y, Li L, Shi ZJ, Wang J, Li ZH (2013) Porous tantalum rod implant is an effective and safe choice for early-stage femoral head necrosis: a meta-analysis of clinical trials. Eur J Orthop Surg Traumatol 23(2):211–217CrossRefPubMed
11.
Moher D, Liberati A, Tetzlaff J, Altman DG, PRISMA Group (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. J Clin Epidemiol 62(10):1006–1012CrossRefPubMed
12.
Steinberg ME, Hayken GD, Steinberg DR (1995) A quantitative system for staging avascular necrosis. J Bone Joint Surg Br 77(1):34–41CrossRefPubMed
13.
Gardeniers JW (1992) A new international classification of osteonecrosis of the ARCO Committee on terminology and classification. J Jpn Orthop Assoc 66:18–20
14.
Harris WH (1969) Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. An end-result study using a new method of result evaluation. J Bone Joint Surg Am 51(4):737–755CrossRefPubMed
15.
von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP, Initiative STROBE (2014) The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Int J Surg 12(12):1495–1499CrossRef
16.
Zhang X, Wang J, Xiao J, Shi Z (2016) Early failures of porous tantalum osteonecrosis implants: a case series with retrieval analysis. Int Orthop 40(9):1827–1834CrossRefPubMed
17.
Liu Y, Yan L, Zhou S, Su X, Cao Y, Wang C, Liu S (2016) Tantalum rod implantation for femoral head osteonecrosis: survivorship analysis and determination of prognostic factors for total hip arthroplasty. Int Orthop 40(7):1397–1407CrossRefPubMed
18.
Miao H, Ye D, Liang W, Yao Y (2015) Effect of osteonecrosis intervention rod versus core decompression using multiple small drill holes on early stages of necrosis of the femoral head: a prospective study on a series of 60 patients with a minimum 1-year-follow-up. Open Orthop J 9:179–184CrossRefPubMedPubMedCentral
19.
Floerkemeier T, Thorey F, Daentzer D, Lerch M, Klages P, Windhagen H, von Lewinski G (2011) Clinical and radiological outcome of the treatment of osteonecrosis of the femoral head using the osteonecrosis intervention implant. Int Orthop 35(4):489–495CrossRefPubMed
20.
Aldegheri R, Taglialavoro G, Berizzi A (2007) The tantalum screw for treating femoral head necrosis: rationale and results. Strateg Trauma Limb Reconstr 2(2–3):63–68CrossRef
21.
Shuler MS, Rooks MD, Roberson JR (2007) Porous tantalum implant in early osteonecrosis of the hip: preliminary report on operative, survival, and outcomes results. J Arthroplast 22(1):26–31CrossRef
22.
Tsao AK, Roberson JR, Christie MJ, Dore DD, Heck DA, Robertson DD, Poggie RA (2005) Biomechanical and clinical evaluations of a porous tantalum implant for the treatment of early-stage osteonecrosis. J Bone Joint Surg Am 87(Suppl 2):22–27PubMed
23.
Bobyn JD, Poggie RA, Krygier JJ, Lewallen DG, Hanssen AD, Lewis RJ, Unger AS, O'Keefe TJ, Christie MJ, Nasser S, Wood JE, Stulberg SD, Tanzer M (2004) J Bone Joint Surg Am 86-A(Suppl 2):123–219CrossRef
24.
Tanzer M, Bobyn JD, Krygier JJ, Karabasz D (2008) Histopathologic retrieval analysis of clinically failed porous tantalum osteonecrosis implants. J Bone Joint Surg Am 90(6):1282–1289CrossRefPubMed
25.
Steinberg ME, Steinberg DR (2004) Classification systems for osteonecrosis: an overview. Orthop Clin N Am 35(3):273–283CrossRef
26.
Schmitt-Sody M, Kirchhoff C, Mayer W, Goebel M, Jansson V (2008) Avascular necrosis of the femoral head: inter- and intraobserver variations of Ficat and ARCO classifications. Int Orthop 32(3):283–287CrossRefPubMed
27.
Liu ZH, Guo WS, Li ZR, Cheng LM, Zhang QD, Yue DB, Shi ZC, Wang BL, Sun W, Zhang NF (2014) Porous tantalum rods for treating osteonecrosis of the femoral head. Genet Mol Res 13(4):8342–8352CrossRefPubMed
28.
Veillette CJ, Mehdian H, Schemitsch EH, McKee MD (2006) Survivorship analysis and radiographic outcome following tantalum rod insertion for osteonecrosis of the femoral head. J Bone Joint Surg Am 88(Suppl 3):48–55PubMed
29.
Zhao D, Zhang Y, Wang W, Liu Y, Li Z, Wang B, Yu X (2013) Tantalum rod implantation and vascularized iliac grafting for osteonecrosis of the femoral head. Orthopedics 36(6):789–795CrossRefPubMed
30.
Ito H, Matsuno T, Minami A (2006) Relationship between bone marrow edema and development of symptoms in patients with osteonecrosis of the femoral head. AJR Am J Roentgenol 186:1761–1770CrossRefPubMed
31.
Malizos KN, Papasoulis E, Dailiana ZH, Papatheodorou LK, Varitimidis SE (2012) Early results of a novel technique using multiple small tantalum pegs for the treatment of osteonecrosis of the femoral head: a case series involving 26 hips. J Bone Joint Surg Br 94(2):173–178CrossRefPubMed
32.
Xu M, Peng D (2011) Mesenchymal stem cells cultured on tantalum used in early-stage avascular necrosis of the femoral head. Med Hypotheses 76(2):199–200CrossRefPubMed
33.
Olsen M, Lewis PM, Morrison Z, McKee MD, Waddell JP, Schemitsch EH (2016) Total hip arthroplasty following failure of core decompression and tantalum rod implantation. Bone Joint J 98-B(9):1175–1179CrossRefPubMed
34.
Lee GW, Park KS, Kim DY, Lee YM, Eshnazarov KE, Yoon TR (2016) Results of total hip arthroplasty after core decompression with tantalum rod for osteonecrosis of the femoral head. Clin Orthop Surg 8(1):38–44CrossRefPubMedPubMedCentral
Metadata
Title
What is the rate of patients undergoing a total hip arthroplasty after core decompression and insertion of a tantalum rod in osteonecrosis of the femoral head: a systematic review
Authors
Jean-Charles Aurégan
Benoît Villain
Thierry Bégué
Publication date
01-07-2018
Publisher
Springer Berlin Heidelberg
Published in
International Orthopaedics / Issue 7/2018
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-018-3961-4

Other articles of this Issue 7/2018

International Orthopaedics 7/2018 Go to the issue

Original Paper

Osteonecrosis in sickle cell disease patients from Bahia, Brazil: a cross-sectional study

Original Paper

Application of combined porous tantalum scaffolds loaded with bone morphogenetic protein 7 to repair of osteochondral defect in rabbits*

Review Article

Early-stage osteonecrosis of the femoral head: where are we and where are we going in year 2018?

Original Paper

Quality of life of patients with osteonecrosis of the femoral head: a multicentre study

Correction

Correction to: Raman spectroscopy reveals differences in molecular structure between human femoral heads affected by steroid-associated and alcohol-associated osteonecrosis

Original Paper

Lesion size measurement in femoral head necrosis