TANTALUM RODS IN TREATMENT OF PATIENTS IN EARLY STAGES OF AVASCULAR NECROSIS OF THE FEMORAL HEAD. PRELIMINARY RESULTS

Abstract

INTRODUCTION: Osteonecrosis of the femoral head usually affects young patients and is caused by disturbance of the femoral head’s blood supply. Bone subchondral necrosis eventually leads to articular incongruity and secondary arthritis of the hip joint.

AIM: To study the adequacy and outcome of tantalum rods implantation in patients with avascular necrosis of the femoral head (up to grade III, according to Ficat’s classification)

PATIENTS AND METHOD: 25 patients with 30 affected hips (5 with bilateral lesions) have been treated, the last 5 years, by tantalum rod implantation. The mean age was 37 years and the mean time of follow up 20 months (6–48), for 24 patients. In four hips we had type III lesions and in the rest type II.

RESULTS: The postoperative evaluation included radiological and clinical (Harris Hip Score – HHS) examination. All patients with type II osteonecrosis had a statistically significant increased HHS score, 6 months and 1 year after tantalum implanting. One patient, with a type III lesion, was subjected in total hip replacement because of disease’s progression, 1 year later. The two others had serious pain relief and improved range of hip motion.

DISCUSSION: Implantation of tantalum rods can be a method of choice in treatment of early stages of AVN of the femoral head. The implant achieves decompression, supports the subchondral plate of the necrotic areas and probably induces bone re-generation. Studies in more patients and with extended follow up time will be helpful for method’s evaluation.