title: Total hip arthroplasty following failure of core decompression and tantalum rod implantation.
abstract: OBJECTIVE
  One method of femoral head preservation following avascular necrosis (AVN) is core decompression and insertion of a tantalum rod. However, there may be a high failure rate associated with this procedure. The purpose of this study was to document the clinical and radiological outcomes following total hip arthroplasty (THA) subsequent to failed tantalum rod insertion.
  
  
  METHODS
  A total of 37 failed tantalum rods requiring total hip arthroplasty were identified from a prospective database. There were 21 hips in 21 patients (12 men and nine women, mean age 37 years, 18 to 53) meeting minimum two year clinical and radiographic follow-up whose THAs were carried out between November 2002 and April 2013 (mean time between tantalum rod implantation and conversion to a THA was 26 months, 6 to 72). These were matched by age and gender to individuals (12 men, nine women, mean age 40 years, 18 to 58) receiving THA for AVN without prior tantalum rod insertion.
  
  
  RESULTS
  There were no functional outcome differences between the two groups. Tantalum residue was identified on all post-operative radiographs in the tantalum group. Linear wear rates were comparable between groups with no evidence of catastrophic wear in either group.
  
  
  CONCLUSIONS
  In the short term, tantalum rod implantation does not demonstrate an adverse effect on subsequent total joint replacement surgery. There is however, a high rate of retained tantalum debris on post-operative radiographs and thus there is an unknown risk of accelerated articular wear necessitating longer term study. Cite this article: Bone Joint J 2016;98-B:1175-9.
authors: St. Michael's Hospital, University of Toronto, 30 Bond Street, Toronto, ON, M5B1W8, Canada.
authors: M
authors: M
authors: Olsen
authors: Cwm Taf University Local Health Board, Prince Charles & Royal Glamorgan Hospitals, South Wales, UK.
authors: P M
authors: PM
authors: Lewis
authors: St. Michael's Hospital, University of Toronto, 30 Bond Street, Toronto, ON, M5B1W8, Canada.
authors: Z
authors: Z
authors: Morrison
authors: St. Michael's Hospital, University of Toronto, 30 Bond Street, Toronto, ON, M5B1W8, Canada.
authors: M D
authors: MD
authors: McKee
authors: St. Michael's Hospital, University of Toronto, 30 Bond Street, Toronto, ON, M5B1W8, Canada.
authors: J P
authors: JP
authors: Waddell
authors: London Health Sciences Centre, Western University, 339 Windermere Rd, London, ON, Canada.
authors: E H
authors: EH
authors: Schemitsch
mesh_terms: D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D016208:Databases, Factual; D019299:Decompression, Surgical / Q000009:adverse effects* / Q000379:methods; D005260:Female; D005271:Femur Head Necrosis / Q000175:diagnosis* / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D016268:Internal Fixators / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D016059:Range of Motion, Articular / Q000502:physiology; D012086:Reoperation / Q000379:methods; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013635:Tantalum / Q000009:adverse effects* / Q000627:therapeutic use; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D013635:Tantalum
keywords: Avascular necrosis; Tantalum rod; Total hip arthroplasty