OUTCOME OF TANTALUM IMPLANTS IN ADVANCED AVN

Abstract

A tantalum AVN implant was used in sixteen patients with advanced AVN (Grade 3/4). No reports have been published of use of this implant in advanced disease. Outcomes included radiological, SF36, Harris hip score and secondary surgeries. HHS improved from fifty-two to seventy. SF36 scores approached controls. At over one year average follow-up five patients are revised to THA, however, all hips except one have at least minor pain. Revisions occurred in older patients or those with 100% head involvement. In younger patients, with up to 50% head involvement, this technique seems to be a viable option for advanced AVN. Evaluation of tantalum AVN implants in patients with advanced AVN. In younger patients, with up to 50% hip head involvement, this technique seems to be a viable option for advanced AVN. Revisions in general are in older patients or those with 100% head involvement.

Most treatment options have had poor outcomes with advanced AVN. Surgeons generally perform THA or core decompression in these cases. Market pressure for a non-vascularized option to fill the channel after decompression has resulted in new implants. A tantalum device has been designed to fill the post-core decompression channel to allow subchondral support. This is a minimally invasive procedure with theoretically low morbidity. The average orthopedic surgeon would have no difficulty in the use of this implant.

HHS improved from fifty-two to seventy. SF36 scores were below age-matched controls. At over one-year average follow-up five patients are revised to THA, however, all hips except one have at least minor pain. Revisions in general are in older patients or those with 100% involvement. In younger patients, with up to 50% head involvement, this technique seems to be a viable option.

This device was used in a prospective cohort of sixteen patients with advanced AVN (Grade 3/4) with femoral head fracture/collapse. Operative technique including reduction of the fracture allows for improved results. Outcomes included radiological parameters (advancing disease, placement, ingrowth), SF36, Harris hip score and secondary surgeries.