增材制造TaBw01多孔钽棒在股骨头ARCO II期骨坏死中的应用

Application of additive manufacturing TaBw01 porous tantalum rod in ARCO stage II osteonecrosis of the femoral head.

作者信息

Huang Jingjie, Jiang Yifan, Peng Yang, Hao Lina, Xiong Ran, Su Tiao, Chen Guangxing

机构信息

Center for Joint Surgery, Southwest Hospital, Army Medical University, Gaotanyan Street, Shapingba District, Chongqing, 400038, China.

Chongqing Ruzer Pharmaceutical Company, Qinye Street, Yubei District, Chongqing, 401120, China.

出版信息

J Orthop Surg Res. 2024 Dec 31;19(1):893. doi: 10.1186/s13018-024-05416-1.

DOI:10.1186/s13018-024-05416-1

PMID:39741327

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11689704/

Abstract

PURPOSE

This study aims to investigate the suitable surgical strategies for applying TaBw01 porous tantalum rod across different stages of osteonecrosis of the femoral head (ONFH).

METHODS

TaBw01 tantalum rods were fabricated using type FTaY-1 tantalum powder via the foam impregnation-sintering method. Mechanical testing with the Instron 8801 universal testing machine and finite element analysis (FEA) assessed single tantalum rod implantation and impaction bone grafting combined with rod implantation. A total of 86 osteonecrosis of the femoral head (ONFH) patients (94 hips) were treated: the experimental group (45 patients, 50 hips) underwent surgical hip dislocation (SHD) with impaction bone grafting and tantalum rod implantation, while the control group (41 patients, 44 hips) received single rod implantation. Primary failure criteria included femoral head collapse (≥ 2 mm) or total hip arthroplasty. Patient-reported outcomes (PROs), including Harris Hip Score (HHS), Visual Analog Score (VAS), Hip Outcome Score Activities of Daily Living Subscale (HOS-ADL), and Hip Outcome Score Sport-Specific Subscale (HOS-SSS), were analyzed based on Minimum Clinically Important Difference (MCID).

RESULTS

FEA confirmed stresses below the material's yield and compressive strength. At 3 years, survival rates for ARCO (Association Research Circulation Osseous) stage IIb and IIc were higher in the experimental group (100%, 80.38%) than the control group, while stage IIa survival was 100% in the control group. The experimental group also had higher MCID attainment for HHS, HOS-ADL, and HOS-SSS.

CONCLUSIONS

Compared with single TaBw01 implantation, impaction bone grafting combined with TaBw01 implantation via SHD demonstrated superior outcomes for ARCO stage IIb and IIc, with a minimum 2-year follow-up. while single TaBw01 implantation may be more suitable for stage IIa. This study emphasizes the importance of combining biological and biomechanical reconstruction in ONFH treatment.

摘要

目的

本研究旨在探讨应用TaBw01多孔钽棒治疗不同阶段股骨头坏死（ONFH）的合适手术策略。

方法

采用FTaY - 1型钽粉通过泡沫浸渍 - 烧结法制备TaBw01钽棒。使用英斯特朗8801万能试验机进行力学测试，并通过有限元分析（FEA）评估单根钽棒植入以及打压植骨联合钽棒植入情况。共治疗86例股骨头坏死（ONFH）患者（94髋）：试验组（45例患者，50髋）采用手术性髋关节脱位（SHD）联合打压植骨及钽棒植入，而对照组（41例患者，44髋）接受单根钽棒植入。主要失败标准包括股骨头塌陷（≥2 mm）或全髋关节置换术。基于最小临床重要差异（MCID）分析患者报告结局（PROs），包括Harris髋关节评分（HHS）、视觉模拟评分（VAS）、髋关节结局评分日常生活活动子量表（HOS - ADL）以及髋关节结局评分运动特定子量表（HOS - SSS）。