Zusammenfassung
Aseptische Knieendoprothesenlockerungen sind auch heute noch der häufigste Grund für das Versagen eines Knieimplantates. In diesem Kapitel werden wichtige klinische und radiologische Kriterien und deren Wertigkeit betrachtet. Besonderes Augenmerk werden auf die Pathogenese aseptischer Lockerungen, die Konsensus-Klassifikation für periprothetische Membranen und auf Pathomechanismen der abriebbedingten Osteolysen als Ursache für die sog. Partikelkrankheit gelegt. Risikofaktoren, die die Standzeit einer Endoprothese wesentlich beeinflussen, werden erörtert, differenziert nach patientenbezogenen, individuellen Faktoren, implantatbedingten Ursachen und intraoperativen Einflussfaktoren, einschließlich der chirurgischen Qualität. Zusammenfassend zeigt sich, dass sich die Standzeiten von Knieendoprothesen in den letzten Jahren deutlich verbessert haben und das Gesamtrisiko einer Revision gesunken ist.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Literatur
Aspenberg P, van der Vis H (1998) Fluid pressure may cause periprosthetic osteolysis. Particles are not the only thing. Acta Orthop Scand 69(1):1–4
August AC, Aldam CH, Pynsent PB (1986) The McKee-Farrar hip arthroplasty. A long-term study. J Bone Joint Surg Br 68(4):520–527
Bader R, Mittelmeier W, Steinhauser E (2006) Failure analysis of total knee replacement. Basics and methodological aspects of the damage analysis. Orthopade 35(9):896, 898–900, 902–893. https://doi.org/10.1007/s00132-006-0976-0
Blauth W, Hassenpflug J (1991) Hinge endoprosthesis of the knee joint. Long-term results based on the Blauth prosthesis. Orthopade 20(3):206–215
Boos C, Russlies M (2006) Neue Erkenntnisse zur Ursache der aseptischen Lockerung von zementfrei implantierten Knieendoprothesen. Focus MUL 23(2):74–81
Boyle WJ, Simonet WS, Lacey DL (2003) Osteoclast differentiation and activation. Nature 423(6937):337–342. https://doi.org/10.1038/nature01658
Chen K, Li G, Fu D, Yuan C, Zhang Q, Cai Z (2013) Patellar resurfacing versus nonresurfacing in total knee arthroplasty: a meta-analysis of randomised controlled trials. Int Orthop 37(6):1075–1083. https://doi.org/10.1007/s00264-013-1866-9
Cherian JJ, Jauregui JJ, Banerjee S, Pierce T, Mont MA (2015) What host factors affect aseptic loosening after THA and TKA? Clin Orthop Relat Res 473(8):2700–2709. https://doi.org/10.1007/s11999-015-4220-2
Claassen L, Ettinger M, Plaass C, Daniilidis K, Calliess T, Ezechieli M (2014) Diagnostic value of bone scintigraphy for aseptic loosening after total knee arthroplasty. Technol Health Care 22(5):767–773. https://doi.org/10.3233/thc-140850
Clements WJ, Miller L, Whitehouse SL, Graves SE, Ryan P, Crawford RW (2010) Early outcomes of patella resurfacing in total knee arthroplasty. Acta Orthop 81(1):108–113. https://doi.org/10.3109/17453670903413145
Dalton JE, Cook SD, Thomas KA, Kay JF (1995) The effect of operative fit and hydroxyapatite coating on the mechanical and biological response to porous implants. J Bone Joint Surg Am 77(1):97–110. https://doi.org/10.2106/00004623-199501000-00012
Doorn PF, Campbell PA, Amstutz HC (1996) Metal versus polyethylene wear particles in total hip replacements. A review. Clin Orthop Relat Res 329(Suppl):S206–S216. https://doi.org/10.1097/00003086-199608001-00018
Engh CA, Bobyn JD (1988) The influence of stem size and extent of porous coating on femoral bone resorption after primary cementless hip arthroplasty. Clin Orthop Relat Res 231:7–28
Ewald FC (1989) The Knee Society total knee arthroplasty roentgenographic evaluation and scoring system. Clin Orthop Relat Res 248:9–12
Glant TT, Jacobs JJ (1994) Response of three murine macrophage populations to particulate debris: bone resorption in organ cultures. J Orthop Res 12(5):720–731. https://doi.org/10.1002/jor.1100120515
Harris WH (1995) The problem is osteolysis. Clin Orthop Relat Res 311:46–53
Harris WH, Muratoglu OK (2019) The role of crosslinked polyethylene in reducing aggregated costs of total hip arthroplasty in the United States. J Arthroplast 34(6):1089–1092. https://doi.org/10.1016/j.arth.2019.02.038
Harris WH, Schiller AL, Scholler JM, Freiberg RA, Scott R (1976) Extensive localized bone resorption in the femur following total hip replacement. J Bone Joint Surg Am 58(5):612–618
Heinz BC, von Mallek D (2005) Survey of incidents associated with hip and knee replacement devices. Analysis of the surveillance and registration system for medical products for the years 2000–2002. Orthopade 34(1):47–54. https://doi.org/10.1007/s00132-004-0708-2
Herberts P, Malchau H (2000) Long-term registration has improved the quality of hip replacement: a review of the Swedish THR Register comparing 160,000 cases. Acta Orthop Scand 71(2):111–121. https://doi.org/10.1080/000164700317413067
Hofstede SN, Nouta KA, Jacobs W, van Hooff ML, Wymenga AB, Pijls BG, Nelissen RG, Marang-van de Mheen PJ (2015) Mobile bearing vs fixed bearing prostheses for posterior cruciate retaining total knee arthroplasty for postoperative functional status in patients with osteoarthritis and rheumatoid arthritis. Cochrane Database Syst Rev (2):Cd003130. https://doi.org/10.1002/14651858.CD003130.pub3
Hotfiel T, Carl HD, Eibenberger T, Gelse K, Weiss J, Jendrissek A, Swoboda B (2017) Cementless femoral components in bicondylar hybrid knee arthroplasty in patients with rheumatoid arthritis: a 10-year survivorship analysis. J Orthop Surg (Hong Kong) 25(2):2309499017716252. https://doi.org/10.1177/2309499017716252
Howie DW, Vernon-Roberts B, Oakeshott R, Manthey B (1988) A rat model of resorption of bone at the cement-bone interface in the presence of polyethylene wear particles. J Bone Joint Surg Am 70(2):257–263
Koh CK, Zeng I, Ravi S, Zhu M, Vince KG, Young SW (2017) Periprosthetic joint infection is the main cause of failure for modern knee arthroplasty: an analysis of 11,134 knees. Clin Orthop Relat Res 475(9):2194–2201. https://doi.org/10.1007/s11999-017-5396-4
Konig A, Scheidler M, Rader C, Haase M, Eulert J (1998) Is use of the Knee Society Roentgenographic Evaluation and Scoring System for radiologic control of knee prostheses reliable? Z Orthop Ihre Grenzgeb 136(1):70–76. https://doi.org/10.1055/s-2008-1044654
Krenn V, Morawietz L, Perino G, Kienapfel H, Ascherl R, Hassenpflug GJ, Thomsen M, Thomas P, Huber M, Kendoff D, Baumhoer D, Krukemeyer MG, Natu S, Boettner F, Zustin J, Kolbel B, Ruther W, Kretzer JP, Tiemann A, Trampuz A, Frommelt L, Tichilow R, Soder S, Muller S, Parvizi J, Illgner U, Gehrke T (2014) Revised histopathological consensus classification of joint implant related pathology. Pathol Res Pract 210(12):779–786. https://doi.org/10.1016/j.prp.2014.09.017
Lim CT, Goodman SB, Huddleston JI 3rd, Harris AHS, Bhowmick S, Maloney WJ, Amanatullah DF (2017) Weight gain after primary total knee arthroplasty is associated with accelerated time to revision for aseptic loosening. J Arthroplast 32(7):2167–2170. https://doi.org/10.1016/j.arth.2017.02.026
Middleton S, Toms A (2016) Allergy in total knee arthroplasty: a review of the facts. Bone Joint J 98-b(4):437–441. https://doi.org/10.1302/0301-620x.98b4.36767
Morawietz L, Classen RA, Schroder JH, Dynybil C, Perka C, Skwara A, Neidel J, Gehrke T, Frommelt L, Hansen T, Otto M, Barden B, Aigner T, Stiehl P, Schubert T, Meyer-Scholten C, Konig A, Strobel P, Rader CP, Kirschner S, Lintner F, Ruther W, Bos I, Hendrich C, Kriegsmann J, Krenn V (2006) Proposal for a histopathological consensus classification of the periprosthetic interface membrane. J Clin Pathol 59(6):591–597. https://doi.org/10.1136/jcp.2005.027458
Morlock MM, Jager M (2017) Endoprostheses in the elderly: biomaterials, implant selection and fixation technique. Orthopade 46(1):4–17. https://doi.org/10.1007/s00132-016-3361-7
Paxton EW, Inacio MC, Kurtz S, Love R, Cafri G, Namba RS (2015) Is there a difference in total knee arthroplasty risk of revision in highly crosslinked versus conventional polyethylene? Clin Orthop Relat Res 473(3):999–1008. https://doi.org/10.1007/s11999-014-4046-3
Pfitzner T, Perka C, von Roth P (2017) Unicompartmental vs. total knee arthroplasty for medial osteoarthritis. Z Orthop Unfall 155(5):527–533. https://doi.org/10.1055/s-0043-107237
Rader CP, Lohr J, Wittmann R, Eulert J (1996) Results of total knee arthroplasty with a metal-backed patellar component. A 6-year follow-up study. J Arthroplast 11(8):923–930
Rader CP, Henssler J, Rolf O (2014) Reasons and risk factors of knee replacement revisions. OUP 7:370–375
Rand JA, Trousdale RT, Ilstrup DM, Harmsen WS (2003) Factors affecting the durability of primary total knee prostheses. J Bone Joint Surg Am 85(2):259–265. https://doi.org/10.2106/00004623-200302000-00012
Robertsson O, Knutson K, Lewold S, Lidgren L (2001) The Swedish Knee Arthroplasty Register 1975–1997: an update with special emphasis on 41,223 knees operated on in 1988–1997. Acta Orthop Scand 72 (5):503–513. https://doi.org/10.1080/000164701753532853
Robertsson O, Sundberg M, Sezgin EA, Lidgren L, W-Dahl A (2019) Higher risk of loosening for a four-pegged TKA tibial baseplate than for a stemmed one: a register-based study. Clin Orthop Relat Res. https://doi.org/10.1097/corr.0000000000000774
Ryd L, Albrektsson BE, Carlsson L, Dansgard F, Herberts P, Lindstrand A, Regner L, Toksvig-Larsen S (1995) Roentgen stereophotogrammetric analysis as a predictor of mechanical loosening of knee prostheses. J Bone Joint Surg Br 77(3):377–383
Schmalzried TP, Callaghan JJ (1999) Wear in total hip and knee replacements. J Bone Joint Surg Am 81(1):115–136. https://doi.org/10.2106/00004623-199901000-00016
Shah SH, Schwartz BE, Schwartz AR, Goldberg BA, Chmell SJ (2017) Total knee arthroplasty in the younger patient. J Knee Surg 30(6):555–559. https://doi.org/10.1055/s-0036-1593619
Sharkey PF, Hozack WJ, Rothman RH, Shastri S, Jacoby SM (2002) Insall Award paper. Why are total knee arthroplasties failing today? Clin Orthop Relat Res 404:7–13. https://doi.org/10.1097/00003086-200211000-00003
Sharkey PF, Lichstein PM, Shen C, Tokarski AT, Parvizi J (2014) Why are total knee arthroplasties failing today – has anything changed after 10 years? J Arthroplast 29(9):1774–1778. https://doi.org/10.1016/j.arth.2013.07.024
Spangehl MJ, Masri BA, O’Connell JX, Duncan CP (1999) Prospective analysis of preoperative and intraoperative investigations for the diagnosis of infection at the sites of two hundred and two revision total hip arthroplasties. J Bone Joint Surg Am 81(5):672–683. https://doi.org/10.2106/00004623-199905000-00008
Spreckelsen L von, Hahne HJ, Hassenpflug J (1998) Patellofemoral contact zones in knee endoprostheses. Z Orthop Ihre Grenzgeb 136(6):560–565
Steinhauser E, Burgkart R, Gerdesmeyer L (2006) Biomechanical aspects of revision components for knee arthroplasty. Orthopade 35(2):128–135. https://doi.org/10.1007/s00132-005-0911-9
Sun K, Li H (2017) Body mass index as a predictor of outcome in total knee replace: a systemic review and meta-analysis. Knee 24(5):917–924. https://doi.org/10.1016/j.knee.2017.05.022
Thomas P (2003) Allergic reactions to implant materials. Orthopade 32(1):60–64. https://doi.org/10.1007/s00132-002-0413-y
Trampuz A, Hanssen AD, Osmon DR, Mandrekar J, Steckelberg JM, Patel R (2004) Synovial fluid leukocyte count and differential for the diagnosis of prosthetic knee infection. Am J Med 117(8):556–562. https://doi.org/10.1016/j.amjmed.2004.06.022
Walker T, Rutkowski L, Innmann M, Panzram B, Herre J, Gotterbarm T, Aldinger PR, Merle C (2019) Unicondylar knee arthroplasty using cobalt-chromium implants in patients with self-reported cutaneous metal hypersensitivity. Bone Joint J 101-b(2):227–232. https://doi.org/10.1302/0301-620x.101b2.bjj-2018-0778.r1
Wilhelm SK, Henrichsen JL, Siljander M, Moore D, Karadsheh M (2018) Polyethylene in total knee arthroplasty: where are we now? J Orthop Surg (Hong Kong) 26(3):2309499018808356. https://doi.org/10.1177/2309499018808356
Yang SY, Ren W, Park Y, Sieving A, Hsu S, Nasser S, Wooley PH (2002) Diverse cellular and apoptotic responses to variant shapes of UHMWPE particles in a murine model of inflammation. Biomaterials 23(17):3535–3543
Ziebuhr W, Loessner I, Krimmer V, Hacker J (2001) Methods to detect and analyze phenotypic variation in biofilm-forming Staphylococci. Methods Enzymol 336:195–205. https://doi.org/10.1016/s0076-6879(01)36590-4
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Section Editor information
Rights and permissions
Copyright information
© 2023 Springer-Verlag GmbH Deutschland, ein Teil von Springer Nature
About this chapter
Cite this chapter
Rolf, O., Rader, C. (2023). Aseptische Knieprothesenlockerung. In: Wirtz, D.C., Reichel, H., Matziolis, G., Pfitzner, T. (eds) Endoprothetik des Kniegelenkes. AE-Manual der Endoprothetik. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-65175-9_16
Download citation
DOI: https://doi.org/10.1007/978-3-662-65175-9_16
Published:
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-662-65174-2
Online ISBN: 978-3-662-65175-9
eBook Packages: Medicine (German Language)