Tantalum rod insertion combined with vascularized pedicled iliac graft in the treatment of early-stage femur head necrosis for young and middle-aged

YAN Weiqiang; ZHANG Min

doi:10.3969/j.issn.1674-666X.2013.02.002

Abstract：Objective To study the clinical outcome of tantalum rod insertion combined with vascularized pedicled iliac bone graft in the treatment of early-stage osteonecrosis of the femoral head for young and middle-aged. Methods Clinical data of 11 patients (15 hips) with early-stage femur head necrosis were collected and analyzed retrospectively, those patients were treated by tantalum rod insertion combined with vascularized pedicled iliac bone graft from October 2007 to January 2012 in affiliated Jiangmen Hospital of Zhongshan University. Operative time, estimate blood loss were recorded, tantalum rod loosening, breakage as well as the improvement of symptom after the surgery were observed, and Harris scores of hip joint and radiological results were evaluated at the last follow-up. Results All patients were followed up for 12-60 months, with the average of 24 months. The average surgical time was 70 minuties (60 to 100 min), and the average estimate blood loss was 280 mL (200-400 mL). Pain of hip relieved or resolved, the Harris score at the last follow-up (85 ± 4) was higher than the preoperative one (62 ± 3), the difference had statistical significance (t = 6.505, P = 0.000). Radiographs showed that no femoral head collapse occurred, and there were no bone necrosis tendency in the area of bone graft. During the follow-up, no tantalum rod loosening or breakage were found, and no internal fixator rejection reaction had happened. Conclusion Tantalum rod insertion combined with vascularized pedicled iliac bone graft is an effective method for early-stage osteonecrosis of the femoral head because it can improve blood supply and also can provide enough mechanical support, so as to prevent the progress of femoral head collapse and to get satisfied effect of function improvement.