gms | German Medical Science

Objectives: The purpose of our study was to assess survivorship and report the clinical and radiograghic outcome in which osteonecrosis of femoral head was treated with core depression, bone grafting combined with porous tantalum implant.

Methods: 41 patients 43 consecutive hips) with osteonecrosis of femoral head (ARCO Stage 2-3, JIC classification B-C2) treat with core depression, allograft bone grafting combined with porous tantalum implant between January 2008 and December 2011 were retrospectively reviewed. Patients were evaluated radiologically using the ARCO stages and clinically using Harris hip score. The end point of the survivorship analysis was total hip arthroplasty.

Results and Conclusion: Mean follow-up time was 63(12-99) months. The porous tantalum rods survival rate was 100% after 12months, 87.5% (95% CI, 95.4% to 72.1%) after 24months, 82.5% (95% CI 91.2% to 66.8%) after 36months, 70% (95% CI, 81.8% to 53.1%) after 60 months. Preoperative Stage 2b according to ARCO stage had the overall survival rate of 100.0%, stage 2c 66.7% (95% CI, 84.6% to 37.6%), stage 3a 22.2% (95% CI, 51.3% to 3.3%). JIC classification Type B survival rate was 100%, Type C1 79.2% (95% CI 90.7% to 57.0%), Type C2 30% (95% CI 57.8% to 7.1%). The preoperative Harris hip score was 76.9±9.3 (51 to 86) while the postoperative HHS is 93.0±4.8 points (79 to 100 point, P<0.05), . Core depression, bone grafting combine with porous tantalum implant in the mid-term follow-up outcome showed an encouraging survival rate in patients with ONFN in early stages. Proper patient selection was the key in Porous tantalum implantation.