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Alternative kopferhaltende Verfahren bei Hüftkopfnekrose: Tissue Engineering, Zukunftsperspektive

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Fortschritte in der speziellen Hüftchirurgie

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Zusammenfassung

Bei der Hüftkopfnekrose handelt es sich um das Absterben des zellulären Teils des Knochens mit anschließenden strukturellen Veränderungen, die zu einem fortschreitenden Zusammenbruch des Hüftkopfes führen, gefolgt von degenerativer Arthrose des Hüftgelenks und künstlichem Gelenkersatz. Die Erhaltung des eigenen Hüftkopfes anstelle von künstlichen Implantaten ist vor allem bei jungen Patienten mit starker Beteiligung des Kopfes das ideale Ziel. Die vaskularisierte Knochentransplantation und die transtrochantäre Osteotomie haben bei mittelgroßen bis großen Läsionen, bei denen der gewichtstragende Teil des Hüftkopfes betroffen ist und bei denen die Nekrose bereits vor dem Kollaps eingetreten ist, nach einer Langzeitbeobachtung gute Ergebnisse gezeigt. Diese Verfahren erfordern jedoch sehr anspruchsvolle Techniken, lange Operationszeiten und langfristige Rehabilitationszeiten, die mit unvorhersehbaren Ergebnissen und hohen Komplikationsraten verbunden sind. Wir stellen ein neues Tissue-Engineering-Verfahren vor, bei dem ex vivo kultivierte, expandierte Stammzellen aus dem Knochenmark in Kalziummetaphosphatkügelchen als alternative minimalinvasive Methode anstelle einer technisch anspruchsvollen Technik in schwierigen Fällen von Osteonekrose eingesetzt werden.

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Author information

Authors and Affiliations

  1. Abteilung für orthopädische Chirurgie, Medizinische Fakultät, Krankenhaus der Kyungpook National University, Daegu, Südkorea

    Shin-Yoon Kim

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  1. Shin-Yoon Kim
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Editors and Affiliations

  1. Abteilung für Orthopädie, Uniklinik RWTH Aachen, Aachen, Deutschland

    Wolf R. Drescher

  2. Abteilung für orthopädische Chirurgie, Seoul National University Bundang Hospital, Seongnam, Korea (Republic of)

    Kyung-Hoi Koo

  3. Orthopaedic Surgery, Hip and Knee Replacement, Hospital of Special Surgery, New York, USA

    Russell E. Windsor

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Kim, SY. (2023). Alternative kopferhaltende Verfahren bei Hüftkopfnekrose: Tissue Engineering, Zukunftsperspektive. In: Drescher, W.R., Koo, KH., Windsor, R.E. (eds) Fortschritte in der speziellen Hüftchirurgie. Springer, Cham. https://doi.org/10.1007/978-3-031-27202-8_12

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  • DOI: https://doi.org/10.1007/978-3-031-27202-8_12

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  • Publisher Name: Springer, Cham

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  • Online ISBN: 978-3-031-27202-8

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