Associate Professor Ye Zhewei, Department of Orthopedics, Union Hospital of Huazhong University of Science and Technology
Ischemic necrosis of the femoral head is a disease that causes localized poor blood flow to the femoral head due to various reasons, resulting in ischemia, necrosis of bone cells, fracture of bone trabeculae and collapse of the femoral head. This difficult-to-treat disease has a high disability rate and seriously affects the life and work of patients. Currently, about 30 million people worldwide suffer from this disease. In China, there are about 4 million patients with ischemic necrosis of the femoral head. Zhewei Ye, Department of Orthopedics, Wuhan Union Hospital
Artificial joint replacement is one of the effective methods to treat advanced femoral head necrosis; however, the artificial joints currently designed and manufactured have a certain life span (about 15-30 years on average). Once there is wear and tear and loosening of the artificial joint, young patients will have to face the possibility of having to undergo joint revision surgery twice or even three times in their lifetime.
The theory is that the intraosseous pressure in the necrotic femoral head is increased, and the decompression of the medullary core will reduce the intraosseous pressure, improve the blood circulation in the femoral head, and relieve the pain. However, after decompression of the medullary core, the mechanical strength of the femoral head is further reduced, making it more prone to collapse until it is repaired. To remedy this deficiency, medical experts have devised many ways to enhance the strength of the drilled decompression area and provide a stronger mechanical support effect, but each method currently has its limitations.
In recent years, scientists have developed a bone trabecular metal, the Femoral Head Necrosis Reconstruction Tantalum Rod, to treat early femoral head necrosis. The porous tantalum metal is strong enough to withstand physiological loads, which provides excellent support for a femoral head that is about to collapse. The pore spacing of the porous tantalum rods is large and fully interconnected, close to that of human bone trabeculae, allowing for reliable and rapid bone growth. At the same time, tantalum metal has good biocompatibility, allowing human bone tissue to grow well into the pores of the metal tantalum rods, making human bone and metal tantalum rods one and the same. In addition, its elastic modulus is similar to that of bone, which can reduce stress masking.
The combined use of marrow core decompression and porous tantalum rod implantation for the treatment of femoral head necrosis can provide structural support for subchondral bone, delaying the time of femoral head collapse and postponing total hip replacement; at the same time, it can avoid the pathological damage caused by vascularized fibula grafting and avascular bone grafting techniques. This procedure is the most advanced minimally invasive method for the treatment of femoral head necrosis, especially for patients with early stage femoral head necrosis. Compared with traditional surgery, this method has the advantages of less bleeding, less trauma, shorter postoperative recovery time and lower surgical risk.