Tantalum rod implantation with vascularized bone transplantation has been reported to be an effective method for the treatment of osteonecrosis of the femoral head (ONFH). However, long-term follow-up results were unclear. Sixty-five patients (71 hips) with ONFH treated with this technique were retrospectively reviewed. According to the Association Research Circulation Osseous (ARCO) classification, 21 hips were stage II, 30 were stage III, and 15 were stage IV. Sixty-one patients (66 hips) were followed for more than 10 years. Fifteen hips had to be converted to total hip arthroplasty (THA), the proportion of THA conversion surgery over 10 years postoperative was 4.76% for stage II, 16.7% for stage III, and 60% for stage IV, respectively. The 10-year joint-preserving success rate of the entire group was 77.2%. The Harris Hip Score (HHS) in the patients not receiving THA therapy increased from a mean of 51.35 points (ranged from 32 to 62 points) to 90.12 points (ranged from 72 to 99 points). The technique of tantalum rod implantation with vascularized bone grafting was an effective joint-preserving method for the treatment of ARCO stage II-III ONFH.
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