Total Hip Arthroplasty Following Failure of Core Decompression and Tantalum Rod Insertion for Femoral Head Avascular Necrosis
Bibliographic record
Abstract
Introduction: One method of femoral head preservation following avascular necrosis (AVN) is core decompression and Tantalum Rod insertion. There is, however, a published failure rate of up to 32% at 4 years. The purpose of the present study was to document the clinical and radiological outcome following Total Hip Arthroplasty (THA) subsequent to failed Tantalum Rod insertion. Methods: Twenty-five failed Tantalum Rod insertions subsequently requiring THA were identified from a prospectively updated database. Seventeen patients met minimum 2 year clinical and radiographic follow-up criteria. St. Michael9s Hip (SMH) scores were compared to a matched cohort of patients with THA for AVN without prior Tantalum Rod insertion. Postoperative radiographs were reviewed assessing component alignment, linear wear (Dorr & Wan) and presence of tantalum residue within the joint space. Results: Nine females and eight males underwent removal of a Tantalum Rod with subsequent THA between May 2005 and March 2010. The mean time between Tantalum Rod insertion and conversion to THA was 23 months (range 6–48) with a mean follow-up of 3.5 years (range 2–5). At each follow-up interval the mean SMH scores were comparable between the two groups (p = 0.445). Femoral stem alignment (p = 0.428) and acetabular cup inclination (p = 0.723) were comparable between groups. Articular tantalum residue was identified in 12 of 17 articulations (7 mild, 3 moderate, 2 severe). Linear wear rates were comparable between the tantalum group (0.07 mm/yr, range 0.01–0.40) and controls (0.07 mm/yr, range 0.02–0.21, p = 0.951). There was no evidence of catastrophic wear. Conclusion: Tantalum rod conversion to THA in the young adult patient with AVN reveals no early catastrophic sequelae. In the short term, Tantalum Rod insertion does not demonstrate a deleterious effect on subsequent total joint replacement surgery. There is, however, a high rate of retained tantalum debris within the effective joint space with the procedure and thus there is an unknown risk of accelerated articular wear necessitating longer term study.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".