Therapeutic effect of porous tantalum implantation for osteonecrosis of the femoral head and construction of a prognostic model

doi:10.3969/j.issn.2095-4344.2016.47.007

Abstract

Abstract:

BACKGROUND: Porous tantalum implantation is a novel treatment method for osteonecrosis of the femoral head (ONFH), but its therapeutic effect is under discussion.
OBJECTIVE: To analyze the survival data of two kinds of porous tantalum implants for early- and mid-stage ONFH, and to determine the independent prognostic factors.
METHODS: Thirty-four cases of ARCO stages I-III ONFH were enrolled, and 25 patients (31 hips) were treated with porous tantalum implantation (simple group), and the other 9 patients (10 hips) treated with porous tantalum implantation combined with bone allograft (combination group). Afterwards, the Harris scores and total survival rate of hips were recorded; the prognostic factors were analyzed by Cox regression.
RESULTS AND CONCLUSION: The mean follow-up time in the simple and combination groups was (32.9 ±16.8) and (25.3±12.4) months respectively. The Harris scores at the last follow-up in the two groups were both higher than those before surgery, and moreover, the scores were higher in the simple group than the combination group (P < 0.05). The total survival rate of hips significantly differed between groups (P=0.014). Cox regression showed that the history of hormone, accompanied with other chronic diseases, and adverse reactions made effects on the prognosis. These results suggest that porous tantalum implantation is an effective treatment method for ARCO stages I-III ONFH, and it can improve the functional recovery and survival rate of the hips.

中国组织工程研究杂志出版内容重点：生物材料；骨生物材料; 口腔生物材料; 纳米材料; 缓释材料; 材料相容性；组织工程

Key words: Tantalum, Femur Head Necrosis, Tissue Engineering

CLC Number:

R3218

Mao Zi-mu, Yin Kun, Wang Yu-ze, Li Peng-cui, Guo Li, Wei Xiao-chun .

Therapeutic effect of porous tantalum implantation for osteonecrosis of the femoral head and construction of a prognostic model

[J]. Chinese Journal of Tissue Engineering Research, 2016, 20(47): 7043-7050.

Figures/Tables 15

References

[1]Wang XS,Zhuang QY,Weng XS,et al.Etiological and clinical analysis of osteonecrosis of the femoral head in Chinese patients.Chin Med J (Engl).2013;126(2): 290-295.
[2]Morse CG,Mican JM,Jones EC,et al.The incidence and natural history of osteonecrosis in HIV-infected adults. Clin Infect Dis.2007;44(5):739-748.
[3]Mont MA,Cherian JJ,Sierra RJ,et al.Nontraumatic Osteonecrosis of the Femoral Head: Where Do We Stand Today? A Ten-Year Update.J Bone Joint Surg Am.2015;97(19):1604-1627.
[4]Zhang Y,Li L,Shi ZJ,et al.Porous tantalum rod implant is an effective and safe choice for early-stage femoral head necrosis: a meta-analysis of clinical trials.Eur J Orthop Surg Traumatol.2013;23(2):211-217.
[5]Symptomatic multifocal osteonecrosis.A multicenter study. Collaborative Osteonecrosis Group.Clin Orthop Relat Res.1999;(369):312-326.
[6]Sotereanos NG,DeMeo PJ,Hughes TB,et al. Autogenous osteochondral transfer in the femoral head after osteonecrosis.Orthopedics.2008;31(2):177.
[7]Liu G,Wang J,Yang S,et al.Effect of a porous tantalum rod on early and intermediate stages of necrosis of the femoral head.Biomedl Mater.2010;5(6):065003.
[8]Schmitt-Sody M,Kirchhoff C,Mayer W,et al.Avascular necrosis of the femoral head: inter- and intraobserver variations of Ficat and ARCO classifications.Int Orthopaed.2008;32(3):283-287.
[9]Wang LY,Fasulo D.A fast boosting-based screening method forlarge-scale association study in complex traits with genetic heterogeneity.Conf Proc IEEE Eng Med Biol Soc.2006;1:5771-5774．
[10]Valafar F.Pattern recognition techniques in microarray data analysis:a survey.Ann N Y Acad Sci. 2002;980: 41-64．
[11]Zardiackas LD,Parsell DE,Dillon LD,et al.Structure, metallurgy, and mechanical properties of a porous tantalum foam.J Biomed Mater Res. 2001;58(2): 180-187.
[12]Bobyn JD,Stackpool GJ,Hacking SA,et al. Characteristics of bone ingrowth and interface mechanics of a new porous tantalum biomaterial.J Bone Joint Surg Br.1999;81(5):907-914.
[13]Minagar S,Berndt CC,Wen C.Fabrication and Characterization of Nanoporous Niobia, and Nanotubular Tantala, Titania and Zirconia via Anodization.J Funct Biomater. 2015;6(2):153-170.
[14]Whitney GA,Mera H,Weidenbecher M,et al.Methods for producing scaffold-free engineered cartilage sheets from auricular and articular chondrocyte cell sources and attachment to porous tantalum.Biores Open Access. 2012;1(4):157-165.
[15]Wang Q,Zhang H,Li Q,et al.Biocompatibility and osteogenic properties of porous tantalum.Exp Ther Med.2015;9(3):780-786.
[16]Ren B,Zhai Z,Guo K,et al.The application of porous tantalum cylinder to the repair of comminuted bone defects: a study of rabbit firearm injuries.Int J Clin Exp Med. 2015;8(4):5055-5064.
[17]Liu ZH,Guo WS,Li ZR,et al.Porous tantalum rods for treating osteonecrosis of the femoral head.Genet Mol Res.2014;13(4):8342-8352.
[18]赵德伟,谢辉,王本杰,等.带血管蒂髂骨瓣转移联合多孔钽金属棒植入治疗股骨头缺血性坏死[J].中华显微外科杂志,2014,37(1):29-34.
[19]Tanzer M,Bobyn JD,Krygier JJ,et al.Histopathologic retrieval analysis of clinically failed porous tantalum osteonecrosis implants.J Bone Joint Surg Am. 2008; 90(6):1282-1289.
[20]Miao H,Ye D,Liang W,et al.Effect of Osteonecrosis Intervention Rod Versus Core Decompression Using Multiple Small Drill Holes on Early Stages of Necrosis of the Femoral Head: A Prospective Study on a Series of 60 Patients with a Minimum 1-Year-Follow-Up. Open Orthop J. 2015;9:179-184.
[21]胥少汀.骨科手术并发症预防与处理[M].3版.北京:人民军医出版社,2010.
[22]Malizos KN,Papasoulis E,Dailiana ZH,et al.Early results of a novel technique using multiple small tantalum pegs for the treatment of osteonecrosis of the femoral head: a case series involving 26 hips. Bone Joint Surge Br. 2012;94(2):173-178.
[23]Shi J,Chen J,Wu J,et al.Evaluation of the 3D finite element method using a tantalum rod for osteonecrosis of the femoral head.Med Sci Monit. 2014;20:2556-2564.