Hip Resurfacing Arthroplasty after Failure of Tantalum Rod Insertion in Patients with Osteonecrosis of the Femoral Head
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Purpose: The purpose of this study was to examine the clinical outcomes and efficacy of hip resurfacing arthroplasty (HRA) in patients with osteonecrosis of the femoral head after the failure of porous tantalum rod insertion without rod removal. Materials and Methods: Conversion to hip resurfacing arthroplasty was performed in 10 patients (11 hips) with a mean period of 14.9 months after the primary surgery. The mean follow-up period was 73.7 months. Analysis of pre and postoperative range of motion (ROM), University of California at Los Angeles (UCLA) activity score, modified Harris hip score, and visual analog scale (VAS) pain score was performed. Radiographic analysis of component loosening and osteolysis was performed. Results: The postoperative ROM showed significant improvement (P<0.05), excluding flexion contracture. The modified Harris hip score showed improvement from 65.82 to 96.18, the UCLA score showed improvement from 4.18 to 8.00, and the VAS pain score was reduced from 6.09 to 1.80. All scores showed statistically significant improvement (P<0.05). No component loosening or osteolysis was detected by radiographic analysis. Conclusion: Satisfactory results were obtained from conversion hip resurfacing arthroplasty after failure of porous tantalum rod insertion without rod removal. The findings of this study demonstrate the advantages of HRA, including no risk of trochanteric fracture and no bone loss around the tantalum rod. In addition, the remaining porous tantalum rod provided mechanical support, which reduced the potential risk of femoral neck fracture or loosening. This technique can be regarded as a favorable treatment option.
Abstract
Purpose: The purpose of this study was to examine the clinical outcomes and efficacy of hip resurfacing arthroplasty (HRA) in patients with osteonecrosis of the femoral head after the failure of porous tantalum rod insertion without rod removal. Materials and Methods: Conversion to hip resurfacing arthroplasty was performed in 10 patients (11 hips) with a mean period of 14.9 months after the primary surgery. The mean follow-up period was 73.7 months. Analysis of pre and postoperative range of motion (ROM), University of California at Los Angeles (UCLA) activity score, modified Harris hip score, and visual analog scale (VAS) pain score was performed. Radiographic analysis of component loosening and osteolysis was performed. Results: The postoperative ROM showed significant improvement (P<0.05), excluding flexion contracture. The modified Harris hip score showed improvement from 65.82 to 96.18, the UCLA score showed improvement from 4.18 to 8.00, and the VAS pain score was reduced from 6.09 to 1.80. All scores showed statistically significant improvement (P<0.05). No component loosening or osteolysis was detected by radiographic analysis. Conclusion: Satisfactory results were obtained from conversion hip resurfacing arthroplasty after failure of porous tantalum rod insertion without rod removal. The findings of this study demonstrate the advantages of HRA, including no risk of trochanteric fracture and no bone loss around the tantalum rod. In addition, the remaining porous tantalum rod provided mechanical support, which reduced the potential risk of femoral neck fracture or loosening. This technique can be regarded as a favorable treatment option.
참고문헌 (28)
- Vail TP, "Donor-site morbidity with use of vascularized autogenous fibular grafts", J Bone Joint Surg Am, 78, pp.204~211 (1996)[DOI]
- Tang CL, "Donor site morbidity following vascularized fibular grafting", Microsurgery, 18, pp.383~386 (1998)[DOI]
- Floerkemeier T, "Clinical and radiological outcome of the treatment of osteonecrosis of the femoral head using the osteonecrosis intervention implant", Int Orthop, 35, pp.489~495 (2011)[DOI]
- 이건우, "Results of Total Hip Arthroplasty after Core Decompression with Tantalum Rod for Osteonecrosis of the Femoral Head", Clinics in Orthopedic Surgery, 8(1), pp.038~044 (2016), 대한정형외과학회
- Olsen M, "Total hip arthroplasty following failure of core decompression and tantalum rod implantation", Bone Joint J, 98-B, pp.1175~1179 (2016)[DOI]
- Bobyn JD, "Characteristics of bone ingrowth and interface mechanics of a new porous tantalum biomaterial", J Bone Joint Surg Br, 81, pp.907~914 (1999)[DOI]
- Bobyn JD, "Clinical validation of a structural porous tantalum biomaterial for adult reconstruction", J Bone Joint Surg Am, 86-A(Suppl 2), pp.123~129 (2004)[DOI]
- Varitimidis SE, "Outcome after tantalum rod implantation for treatment of femoral head osteonecrosis : 26 hips followed for an average of 3 years", Acta Orthop, 80, pp.20~25 (2009)[DOI]
- Tsao AK, "Biomechanical and clinical evaluations of a porous tantalum implant for the treatment of early-stage osteonecrosis", J Bone Joint Surg Am, 87(Suppl 2), pp.22~27 (2005)[DOI]
- Aldegheri R, "The tantalum screw for treating femoral head necrosis : rationale and results", Strategies Trauma Limb Reconstr, 2, pp.63~68 (2007)[DOI]
- Nadeau M, "Short term clinical outcome of a porous tantalum implant for the treatment of advanced osteonecrosis of the femoral head", Mcgill J Med, 10, pp.4~10 (2007)[DOI]
- Shuler MS, "Porous tantalum implant in early osteonecrosis of the hip : preliminary report on operative, survival, and outcomes results", J Arthroplasty, 22, pp.26~31 (2007)[DOI]
- Veillette CJ, "Survivorship analysis and radiographic outcome following tantalum rod insertion for osteonecrosis of the femoral head", J Bone Joint Surg Am, 88(Suppl 3), pp.48~55 (2006)[DOI]
- Liu G, "Effect of a porous tantalum rod on early and intermediate stages of necrosis of the femoral head", Biomed Mater, 5, pp.065003~ (2010)[DOI]
- Beaulé PE, "Management of Ficat stage III and IV osteonecrosis of the hip", J Am Acad Orthop Surg, 12, pp.96~105 (2004)[DOI]
- Owens JB, "Removal of trabecular metal osteonecrosis intervention implant and conversion to primary total hip arthroplasty", J Arthroplasty, 27, pp.1251~1253 (2012)[DOI]
- Kerboul M, "The conservative surgical treatment of idiopathic aseptic necrosis of the femoral head", J Bone Joint Surg Br, 56, pp.291~296 (1974)[DOI]
- Ha YC, "Prediction of collapse in femoral head osteonecrosis: a modified Kerboul method with use of magnetic resonance images", J Bone Joint Surg Am, 88(Suppl 3), pp.35~40 (2006)[DOI]
- Steinberg ME, "Lesion size measurement in femoral head necrosis", Int Orthop, 42, pp.1585~1591 (2018)[DOI]
- Park CW, "Hip resurfacing arthroplasty for osteonecrosis of the femoral head : implant-specific outcomes and risk factors for failure", J Orthop Translat, 21, pp.41~48 (2020)[DOI]
- Tanzer M, "Histopathologic retrieval analysis of clinically failed porous tantalum osteonecrosis implants", J Bone Joint Surg Am, 90, pp.1282~1289 (2008)[DOI]
- Zhang X, "Early failures of porous tantalum osteonecrosis implants : a case series with retrieval analysis", Int Orthop, 40, pp.1827~1834 (2016)[DOI]
- Fernández-Fairen M, "Analysis of tantalum implants used for avascular necrosis of the femoral head : a review of five retrieved specimens", J Appl Biomater Funct Mater, 10, pp.29~36 (2012)[DOI]
- Daniel J, "Metal-on-metal resurfacing of the hip in patients under the age of 55 years with osteoarthritis", J Bone Joint Surg Br, 86, pp.177~184 (2004)[DOI]
- Clarke MT, "Dislocation after total hip replacement in relation to metal-on-metal bearing surfaces", J Bone Joint Surg Br, 85, pp.650~654 (2003)[DOI]
- Shimmin AJ, "Complications associated with hip resurfacing arthroplasty", Orthop Clin North Am, 36, pp.187~193 (2005)[DOI]
- Mont MA, "Use of metal-on-metal total hip resurfacing for the treatment of osteonecrosis of the femoral head", J Bone Joint Surg Am, 88(Suppl 3), pp.90~97 (2006)[DOI]
- Tai CL, "The effects of necrotic lesion size and orientation of the femoral component on stress alterations in the proximal femur in hip resurfacing-a finite element simulation", BMC Musculoskelet Disord, 15, pp.262~ (2014)[DOI]