Varitimidis Sokratis E, Dimitroulias Apostolos P, Karachalios Theophilos S, Dailiana Zoe H, Malizos Konstantinos N
Department of Orthopedic Surgery, School of Medicine, University of Thessalia, Larissa, Greece.
Acta Orthop. 2009 Feb;80(1):20-5. doi: 10.1080/17453670902804877.
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.
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.
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.
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.
钽棒植入术最近被用于治疗早期股骨头坏死。本研究旨在报告其在疾病塌陷前期和塌陷期应用的早期结果。
我们前瞻性研究了2000年12月至2005年9月间27例行钽棒植入术治疗非创伤性股骨头坏死的患者。采用Steinberg分类法和Harris髋关节评分（HHS）对患者进行影像学和临床评估。疾病分期为II期至IV期。平均随访时间为38（15 - 71）个月。
1例患者（1髋）术后15个月因与手术无关的原因死亡。26髋中13髋的影像学分期无变化，13髋病情恶化。HHS平均从49分提高到85分。6例患者需要转换为全髋关节置换术。当该手术用于III期和IV期时，影像学结果和翻修率均比II期髋关节差。然而，初始评估时塌陷前期和塌陷期患者的术后HHS无差异。以翻修为全髋关节置换术作为终点，6年生存率为70%。
疾病进程似乎未被打断，但多数髋关节的髋关节功能最初有显著改善。钽棒植入术是一种安全的“争取时间”技术，尤其是在其他关节挽救手术不可行时。为获得良好效果，需要恰当选择患者并仔细插入钽棒。
