钽棒置入治疗股骨头坏死的疗效分析及预后模型建立

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

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.