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„Schmerzhafte“ Knieprothese

  • Living reference work entry
  • First Online:
AE-Manual der Endoprothetik

Part of the book series: Springer Reference Medizin ((SRM))

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Zusammenfassung

Bis zu 20 % der Patienten nach Knieprothesenimplantation sind nicht zufrieden. Die Analyse der Ursachen stellt bei insbesondere offensichtlich normalem Röntgenbild eine Herausforderung dar. Der Ausschluss einer tiefen, schleichenden Infektion sollte immer erfolgen. Ganzbeinröntgen, bildwandlergezielte Röntgenaufnahmen mit Vermessung der Gelenklinien sowie computertomografische Aufnahmen erlauben die Erfassung der Position der Knieprothese. Die Analyse der Mechanik beinhaltet die Abklärung der Grundprinzipien der Knieendoprothetik (Alignment, Rotation, knöcherne und ligamentäre Stabilität und Fixation der Prothese). Eine Operation ohne präoperative Abklärung der Ursachen erscheint nicht sinnvoll. Konnten eine oder mehrere mechanische Probleme analysiert werden, besteht nach ausgiebiger Aufklärung und fehlgeschlagener konservativer Therapie die Möglichkeit des einzeitigen Prothesenwechsels mit Korrektur aller Implantationsabweichungen. Diese gewissermaßen Wiederholung der Erstoperation nur mit höher gekoppelter Prothese ist nicht erfolgsversprechend. Das CRPS und die Implantatallergie sind eher unwahrscheinlich und stellen seltene Ausnahmen dar.

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Author information

Authors and Affiliations

  1. Departmentleiter Hüft- und Knieendoprothetik, LKH Murtal/Stolzalpe, Stolzalpe, Österreich

    Martin Pietsch

  2. LKH Murtal/Stolzalpe, Stolzalpe, Österreich

    Siegfried Hofmann

Authors
  1. Martin Pietsch
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  2. Siegfried Hofmann
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Corresponding author

Correspondence to Martin Pietsch .

Editor information

Editors and Affiliations

  1. CMSC, Campus Mitte, Charite Berlin, Berlin, Berlin, Deutschland

    Carsten Perka

  2. Orthopädische Klinik Braunschweig, Herzog-Elisabeth-Hospital, Braunschweig, Niedersachsen, Deutschland

    Karl-Dieter Heller

Section Editor information

  1. Waldkliniken Eisenberg, Eisenberg, Deutschland

    Georg Matziolis

  2. Klinik für Endoprothetik, Knie- und Hüftchirurgie; Department für Bewegungschirurgie, Vivantes Klinikum Spandau, Berlin, Deutschland

    Tilman Pfitzner

  3. Orthopädische Universitätsklinik Ulm am RKU, Ulm, Deutschland

    Heiko Reichel

  4. Universitätsklinikum Bonn, Direktor der Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Bonn, Deutschland

    Dieter Christian Wirtz

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© 2022 Springer-Verlag GmbH Deutschland, ein Teil von Springer Nature

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Pietsch, M., Hofmann, S. (2022). „Schmerzhafte“ Knieprothese. In: Perka, C., Heller, KD. (eds) AE-Manual der Endoprothetik. Springer Reference Medizin. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-55485-2_39-1

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  • DOI: https://doi.org/10.1007/978-3-662-55485-2_39-1

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  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-55485-2

  • Online ISBN: 978-3-662-55485-2

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