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04.05.2018 | Original Paper | Ausgabe 7/2018

International Orthopaedics 7/2018

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

Zeitschrift:
International Orthopaedics > Ausgabe 7/2018
Autoren:
Jean-Charles Aurégan, Benoît Villain, Thierry Bégué

Abstract

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.

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