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Hüftgelenk-Oberflächenersatzendoprothesen

Hip resurfacing arthroplasty

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Zusammenfassung

Oberflächenersatzendoprothesen bieten gegenüber schaftverankerten Endoprothesen Vorteile, insbesondere hinsichtlich der Gelenkstabilität und der geringeren femoralen Knochenresektion. Nach den v. a. durch das Versagen der eingesetzten Implantatmaterialien bedingten schlechten Ergebnissen dieses Konzepts, ergab sich mit Wiederentdeckung der Metall-Metall-Gleitpaarung die Chance einer Renaissance. Durch den Einsatz dieser Paarung, einer zementfrei verankerten Pfanne und einer verbesserten Operationstechnik konnten die kurz- bis mittelfristigen Ergebnisse deutlich verbessert werden.

In unserem Krankengut war bei zu schaftverankerten Hüftendoprothesen vergleichbarer Komplikations- und Revisionsrate im kurz- bis mittelfristigen Verlauf eine höhere funktionelle Kapazität nachweisbar. Da Langzeitergebnisse noch ausstehen, können aber mit der Methode verbundene Risiken wie die Erhöhung der Metallionen-Serumkonzentrationen und der Unmöglichkeit eines Inlaywechsels bei femoral notwendiger Revision noch nicht abgeschätzt werden.

Abstract

In comparison to stemmed total hip replacements, hip resurfacing offers advantages especially in joint stability and amount of femoral bone resection. After the poor results achieved with this concept that were mainly caused by failure of the materials used, reintroduction of the metal-on-metal bearing initiated a renaissance. This bearing, the cementless cup, and the improved surgical technique led to better short- to medium-term results.

Revision and complication rates are now comparable to conventional total hip replacements. The functional capacity of the method is higher. Because long-term results are not available, however, questions remain, for instance, the consequences of the higher metal ion serum concentrations or the impossibility of changing the inlay when femoral revision becomes necessary.

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Authors and Affiliations

  1. Klinik und Poliklinik für Orthopädie, Universitätsklinikum „Carl Gustav Carus“ Dresden

    W.-C. Witzleb, A. Knecht, T. Beichler, T. Köhler & K.-P. Günther

  2. Klinik und Poliklinik für Orthopädie, Universitätsklinikum „Carl Gustav Carus“ Dresden, Fetscherstr. 75, 01307, Dresden

    W.-C. Witzleb

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  1. W.-C. Witzleb
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  2. A. Knecht
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  3. T. Beichler
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  4. T. Köhler
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Correspondence to W.-C. Witzleb.

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Witzleb, WC., Knecht, A., Beichler, T. et al. Hüftgelenk-Oberflächenersatzendoprothesen. Orthopäde 33, 1236–1242 (2004). https://doi.org/10.1007/s00132-004-0718-0

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