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KMID : 0386720050170020113
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Journal of the Korean Hip Society
2005 Volume.17 No. 2 p.113 ~ p.120
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The 2-years follow-up of use of a Tantalum Trabecular Metal System for Early Stage of Osteonecrosis of the Femoral Head
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Roh Kwon-Jae
Kim Jong-Oh
Koh Young-Do
Lee Churl-Woo
Shin Yi-Kyoung
Shin Myeung-Cheol
Yoon Jong-Seok
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Abstract
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Purpose: To evaluate the effectiveness of core decompression using the tantalum trabecular metal system for early stage osteonecrosis of the femoral head at the 2 year follow-up.
Materials and Methods: 29 cases in 22 patients, who received the operation between Jan. and Aug. 2003, with a mean 2 years follow-up, were classified according to the ARCO classification. The mean age of the patients was 42.2 years old, with 16 and 6 males and females, respectively. 7 subjects had bilaterally involvement. Clinical failure was defined as radiologic progression of the head collapse, with aggravation of pain.
Results: According to the preoperative ARCO classification, 6 cases were stage I; I case each at IA medial, IB medial, IB central, IB lateral, IC medial and IC central, and 23 cases were stage II; 1 each at IIA medial and IIB medial, 2 at IIB central, 4 at IIB lateral, 3 at IIC medial, 2 at IIC medial and 10 at IIC lateral. Radiologic progression developed in 10 cases (34.5%), IIB central in 1 case and IIB lateral in 9.7 cases (24.1%), all IIC lateral patients, were determined to be clinical failures, and subsequently needed conversion to total hip arthroplasty.
Conclusion: The tantalum trabecular metal system for early stage osteonecrosis of the femoral head has several advantages over other salvage procedures, these being the easiness in technique, short operation time, no donor site morbidity, immediate postoperative weight bearing and pain reduction, but there is a higher risk of failure using the tantalum trabecular metal system in osteonecrosis of the femoral head with stages are more advanced than ARCO stage IIC or if the lesion is lateral. Therefore, long term follow-up is necessary when using the tantalum trabecular metal system in osteonecrosis of the femoral necrosis, but it can certainly be considered a useful joint salvage procedure in ARCO classes earlier than IIC, as well as in medial and central lesions.
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KEYWORD
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Femoral head, Osteonecrosis, Tantalum, Trabecular metal, Core decompression
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