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Erschienen in:
04.05.2018 | Original Paper
What is the rate of patients undergoing a total hip arthroplasty after core decompression and insertion of a tantalum rod in osteonecrosis of the femoral head: a systematic review
Erschienen in: International Orthopaedics | Ausgabe 7/2018
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Purpose
Core decompression (CD) may be effective when performed during the early stages of osteonecrosis of the femoral head (ONFH). Tantalum may be added as a rod that would allow putting some mechanical constraints on the femoral head. We aimed to estimate the rate of total hip arthroplasty after CD and insertion of a tantalum rod during early stages of OFNH.
Methods
We searched systematically Medline via PubMed and the Cochrane Library. Our primary endpoint was the rate of patients undergoing a total hip arthroplasty after CD and insertion of a tantalum rod. Secondary endpoints were the delay between the initial surgery and the arthroplasty, the functional improvement, and the rate of complications.
Results
We included seven studies reporting the results of 232 patients (297 hips) that were operated on by CD and insertion of a tantalum rod. At a mean follow-up of 26.97 months, 24.63% of the included hips underwent a hip arthroplasty (6–56%, SD = 17.34%). The mean delay between the initial surgery and the arthroplasty was 14.94 months (10.20–22.90; SD = 5.25), the mean improvement of Harris Hip Score was 27.66 (20.20–36.90; SD = 6.48), and the mean rate of femoral fracture was 2.43% (0–13%, SD = 4.89%).
Conclusion
CD and insertion of a tantalum rod may represent a solution in order to improve the mechanical support and to give a rate of conversion in arthroplasty that is acceptable.