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Defektadaptierte Rekonstruktionsstrategien in der Hüftrevisionsendoprothetik

Welches Implantat in welcher Situation? Innovationen und Bewährtes

Bone defect adjusted strategy in revision arthroplasty of the hip

Wich implant in wich situation? Innovations and approved methods

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Zusammenfassung

Hintergrund

Die Hüftrevisionsendoprothetik gewinnt in Deutschland mit etwa 35.000 Operationen jährlich zunehmend an Bedeutung.

Fragestellung

Im Vordergrund stehen eine dauerhaft stabile Verankerung des Pfannenimplantates und des Schaftes im azetabulären und femoralen Knochen, sowie die Wiederherstellung des anatomischen Drehzentrums und die Rekonstruktion des Knochenlagers.

Methoden

Aktuelle Literatur und eigene Erfahrungsbeispiele werden dargestellt.

Ergebnisse und Schlussfolgerung

Neue Entwicklungen aus Forschung und Industrie erweitern die Versorgungsmöglichkeiten. Für ein schlüssiges Therapiekonzept bei der Implantatauswahl sollten Kriterien wie Defektsituation, Defektaufbau, Kombinierbarkeit mit verbliebenen Implantaten, Lockerungs- und Versagensursachen, Implanatallergie und patientenspezifische Parameter berücksichtigt werden.

Abstract

Background

Revision total hip arthroplasty is of rising importance, with 35,000 procedures a year in Germany.

Objectives

Primary stability of the revision implant, reconstruction of the anatomical hip center, reconstruction of bone stock, and permanent secondary integration are the main priorities.

Methods

Current literature and examples from our own experience are presented.

Results and conclusions

Novel developments from basic research and industrial partners extend the possibilities for treating affected patients. For an integrated therapy concept in implant selection criteria, such as situation and structure of the defect, combination with any remaining implants, causes of loosening and failure, implant allergy, and patient-specific parameters should be taken into consideration.

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Authors and Affiliations

  1. Orthopädische Klinik, Universität Regensburg, Kaiser-Karl-V-Allee 3, 93077, Bad Abbach, Deutschland

    B. S. Craiovan, J. Grifka, A. Keshmiri, B. Moser, M. Wörner & T. Renkawitz

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  1. B. S. Craiovan
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  2. J. Grifka
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  3. A. Keshmiri
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  4. B. Moser
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  5. M. Wörner
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  6. T. Renkawitz
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Correspondence to B. S. Craiovan.

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B.S. Craiovan, J. Grifka, A. Keshmiri, B. Moser, M. Wörner und T. Renkawitz geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Craiovan, B., Grifka, J., Keshmiri, A. et al. Defektadaptierte Rekonstruktionsstrategien in der Hüftrevisionsendoprothetik. Orthopäde 44, 366–374 (2015). https://doi.org/10.1007/s00132-015-3103-2

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