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High Failure Rate after Beta-tricalcium Phosphate Grafting for the Treatment of Femoral Head Osteonecrosis: a Retrospective Analysis
Wanshou Guo
China-Japan Friendship Hospital
Corresponding Author
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Background: Non-vascularized bone grafting is a promising head-preserving technique for younger patients diagnosed as non-traumatic osteonecrosis of the femoral head (NONFH). Among the various types of bone grafting techniques, “light-bulb” procedure grafting with synthetic bone substitute is an attractive option. We aimed to assess the effectiveness of using beta-tricalcium phosphate (β-TCP) for the treatment of pre-collapse and early post-collapse lesions NONFH.
Methods: From April 2010 to June 2014, 33 patients (47 hips) with NONFH were treated using the afore-mentioned technique. The clinical and radiological outcomes were recorded and compared statistically between pre- and post-operation. Harris hip score (HHS) was used to evaluate the clinical results, and Association Research Circulation Osseous (ARCO) stage was applied to assess the radiological outcomes.
Results: The 5-years survival rate of using β-TCP grafting was accounting for 25.5%. HHS was decreased from 78.47 to 52.87 points, and a very significant worsening of radiological results were revealed (P < 0.05). 2 hips collapsed more than 2 mm were awaiting for THA, and 33 of the 47 hips had converted to THAs in an average time to failure of 24.24 months postoperatively. Meanwhile, only 4 hips survived without collapse, and 8 hips collapsed less than 2 mm. After surgery, the time onset of head collapse was 3.65 months on average, and the first conversion to THA was performed at 5 months postoperative.
Conclusions: Our results suggest that “light-bulb” procedure grafting with β-TCP sticks presented with a high failure rate in the early postoperative period. It is not proposed for the treatment of pre-collapse and early post-collapse lesions NONFH.
Keywords
Osteonecrosis of the femoral head, Beta-tricalcium phosphate, Head-preserving surgery
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Received 31 Mar, 2020
Editorial decision: Minor revision
On 31 Mar, 2020
Reviewers invited
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Reviewer #1 agreed
On 23 Mar, 2020
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On 20 Mar, 2020
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On 19 Mar, 2020
Editor invited
On 19 Mar, 2020
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Received 29 Feb, 2020
Editorial decision: Major revision
On 29 Feb, 2020
Reviewer #2 agreed
On 28 Feb, 2020
Review #1 received
Received 31 Jan, 2020
Reviewer #1 agreed
On 27 Jan, 2020
Reviewers invited
Invitations sent on 22 Jan, 2020
Editor assigned
On 03 Jan, 2020
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On 02 Jan, 2020
Editor invited
On 02 Jan, 2020
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On 31 Dec, 2019
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Subject Areas
Orthopedic Surgery
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This preprint is under consideration at BMC Musculoskeletal Disorders. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
High Failure Rate after Beta-tricalcium Phosphate Grafting for the Treatment of Femoral Head Osteonecrosis: a Retrospective Analysis
Wanshou Guo
China-Japan Friendship Hospital
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 4
Posted 16 Apr, 2020
No community comments so far
Submission checks complete
On 14 Apr, 2020
No comments provided
Editorial decision: Minor revision
On 08 Apr, 2020
Editor assigned
On 05 Apr, 2020
Submission checks complete
On 04 Apr, 2020
Editor invited
On 04 Apr, 2020
No comments provided
Review #1 received
Received 31 Mar, 2020
Editorial decision: Minor revision
On 31 Mar, 2020
Reviewers invited
Invitations sent on 23 Mar, 2020
Reviewer #1 agreed
On 23 Mar, 2020
Editor assigned
On 20 Mar, 2020
Submission checks complete
On 19 Mar, 2020
Editor invited
On 19 Mar, 2020
No comments provided
Review #2 received
Received 29 Feb, 2020
Editorial decision: Major revision
On 29 Feb, 2020
Reviewer #2 agreed
On 28 Feb, 2020
Review #1 received
Received 31 Jan, 2020
Reviewer #1 agreed
On 27 Jan, 2020
Reviewers invited
Invitations sent on 22 Jan, 2020
Editor assigned
On 03 Jan, 2020
Submission checks complete
On 02 Jan, 2020
Editor invited
On 02 Jan, 2020
First submitted
On 31 Dec, 2019
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Orthopedic Surgery
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: Non-vascularized bone grafting is a promising head-preserving technique for younger patients diagnosed as non-traumatic osteonecrosis of the femoral head (NONFH). Among the various types of bone grafting techniques, “light-bulb” procedure grafting with synthetic bone substitute is an attractive option. We aimed to assess the effectiveness of using beta-tricalcium phosphate (β-TCP) for the treatment of pre-collapse and early post-collapse lesions NONFH.
Methods: From April 2010 to June 2014, 33 patients (47 hips) with NONFH were treated using the afore-mentioned technique. The clinical and radiological outcomes were recorded and compared statistically between pre- and post-operation. Harris hip score (HHS) was used to evaluate the clinical results, and Association Research Circulation Osseous (ARCO) stage was applied to assess the radiological outcomes.
Results: The 5-years survival rate of using β-TCP grafting was accounting for 25.5%. HHS was decreased from 78.47 to 52.87 points, and a very significant worsening of radiological results were revealed (P < 0.05). 2 hips collapsed more than 2 mm were awaiting for THA, and 33 of the 47 hips had converted to THAs in an average time to failure of 24.24 months postoperatively. Meanwhile, only 4 hips survived without collapse, and 8 hips collapsed less than 2 mm. After surgery, the time onset of head collapse was 3.65 months on average, and the first conversion to THA was performed at 5 months postoperative.
Conclusions: Our results suggest that “light-bulb” procedure grafting with β-TCP sticks presented with a high failure rate in the early postoperative period. It is not proposed for the treatment of pre-collapse and early post-collapse lesions NONFH.
Figure 1
Figure 2
Figure 3
Figure 4