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MINERVA ORTOPEDICA E TRAUMATOLOGICA
A Journal on Orthopedics and Traumatology
Minerva Ortopedica e Traumatologica 2007 February;58(1):1-8
Porous tantalum nail in the treatment of necrosis of the femoral head
Bistolfi A., Balboni E., Dolfin M., Damilano M., Testa D., Crova M.
Seconda Clinica Ortopedica Dipartimento di Ortopedia e Traumatologia e Medicina del Lavoro Azienda Ospedaliera CTO, CRF M. Adelaide Torino
Aim. Many techniques are well accepted for the treatment of the necrosis of the femoral head, but concerns still exist about which one can be the most effective. Recently, the tantalum femoral nail has been developed to treat the necrosis, while providing blood and mechanical strength to the epiphysis. The aim of this study was to evaluate the effectiveness of a tantalum femoral rod for osteonecrosis of the femoral head.
Methods. Twelve osteonecrosis of the femoral head (2004-2005) have been evaluated. We used Steinberg classification: the grade was II B in 1 case, II C in 6 cases, III B in 1 case, III C in 2 cases, 4 A in 1 case and 4 B in 1 case. Clinical (HHS) and X-rays evaluations of the patients before surgery and then at 45 days, 3, 6, 12, 25 months have been performed. The study was also integrated with a nuclear magnetic resonance at one year.
Results. The 7 cases of initial necrosis of grade 2 or less had good results, while the other 5 cases with necrosis of grade 3 or higher had failure. MRI executed 1 year after surgery did not demonstrate bone growth ub necrosis area.
Conclusion. The porous tantalum nail is not effective in grade 3 or 4 osteonecrosis of the femoral head, while it gives good results in grade 1 or 2. Nevertheless, in initial-grade osteonecrosis, this implant does not give better results than other cheaper techniques and therefore the latter one recommended.