Olsen M, Lewis P M, Morrison Z, McKee M D, Waddell J P, Schemitsch E H
St. Michael's Hospital, University of Toronto, 30 Bond Street, Toronto, ON, M5B1W8, Canada.
Cwm Taf University Local Health Board, Prince Charles & Royal Glamorgan Hospitals, South Wales, UK.
Bone Joint J. 2016 Sep;98-B(9):1175-9. doi: 10.1302/0301-620X.98B9.37252.
One method of femoral head preservation following avascular necrosis (AVN) is core decompression and insertion of a tantalum rod. However, there may be a high failure rate associated with this procedure. The purpose of this study was to document the clinical and radiological outcomes following total hip arthroplasty (THA) subsequent to failed tantalum rod insertion.
A total of 37 failed tantalum rods requiring total hip arthroplasty were identified from a prospective database. There were 21 hips in 21 patients (12 men and nine women, mean age 37 years, 18 to 53) meeting minimum two year clinical and radiographic follow-up whose THAs were carried out between November 2002 and April 2013 (mean time between tantalum rod implantation and conversion to a THA was 26 months, 6 to 72). These were matched by age and gender to individuals (12 men, nine women, mean age 40 years, 18 to 58) receiving THA for AVN without prior tantalum rod insertion.
There were no functional outcome differences between the two groups. Tantalum residue was identified on all post-operative radiographs in the tantalum group. Linear wear rates were comparable between groups with no evidence of catastrophic wear in either group.
In the short term, tantalum rod implantation does not demonstrate an adverse effect on subsequent total joint replacement surgery. There is however, a high rate of retained tantalum debris on post-operative radiographs and thus there is an unknown risk of accelerated articular wear necessitating longer term study. Cite this article: Bone Joint J 2016;98-B:1175-9.
股骨头缺血性坏死（AVN）后保留股骨头的一种方法是髓芯减压并植入钽棒。然而，该手术可能存在较高的失败率。本研究的目的是记录钽棒植入失败后行全髋关节置换术（THA）的临床和放射学结果。
从一个前瞻性数据库中识别出37根需要行全髋关节置换术的失败钽棒。21例患者的21髋（12例男性和9例女性，平均年龄37岁，18至53岁）满足至少两年的临床和影像学随访，其全髋关节置换术于2002年11月至2013年4月间进行（钽棒植入与转为全髋关节置换术之间的平均时间为26个月，6至72个月）。将这些患者按年龄和性别与未预先植入钽棒而行全髋关节置换术治疗AVN的个体（12例男性，9例女性，平均年龄40岁，18至58岁）进行匹配。
两组之间功能结局无差异。钽棒组所有术后X线片上均发现钽残留。两组之间的线性磨损率相当，两组均无灾难性磨损的证据。
短期内，钽棒植入对随后的全关节置换手术未显示出不利影响。然而，术后X线片上钽碎片残留率较高，因此存在加速关节磨损的未知风险，需要进行长期研究。引用本文：《骨与关节杂志》2016；98 - B：1175 - 9。
