Advertisement

Der Orthopäde

, Volume 47, Issue 9, pp 751–756 | Cite as

Endoprothetik bei aseptischer Femurkopfnekrose

  • M. Betsch
  • M. Tingart
  • A. Driessen
  • V. Quack
  • B. Rath
Leitthema

Zusammenfassung

Hintergrund

Bei der aseptischen Femurkopfnekrose (FKN) handelt es sich um eine progredient verlaufende Perfusionsstörung des Hüftkopfes. Im Verlauf der FKN kommt es häufig zu einem strukturellen Schaden des betroffenen Gelenks, sodass die Implantation einer Hüftgelenksprothese notwendig ist.

Ziel

Der vorliegende Artikel soll den Lesern einen Überblick über die aktuelle Literatur zum Thema Endoprothetik bei Patienten mit FKN geben.

Ergebnisse

Bis in die 1990er-Jahre zeigten sich bei Patienten mit FKN erhöhte Revisionsraten nach Implantation einer Hüftgelenksendoprothese. Aktuelle Untersuchungen weisen jedoch keine signifikanten Unterschiede mehr in den klinischen Ergebnissen nach Hüftprothesenimplantation bei FKN und primärer Arthrose auf. Sichere Verankerungsformen sind zementierte und zementfreie Implantate mit verschiedenen Gleitpaarungsmöglichkeiten.

Zusammenfassung

Trotz des jungen Patientenalters kann auch bei Patienten mit einer FKN nach Implantation einer Hüftgelenksendoprothese mit guten langfristigen klinischen Ergebnissen gerechnet werden.

Schlüsselwörter

Coxa Koxarthrose Gelenkersatz Junge Erwachsene Osteoarthrose 

Abkürzungen

ARCO

Association Research Circulation Osseous

BLD

Beinlängendifferenz

FKN

Aseptische Femurkopfnekrose

TEP

Totalendoprothese

Total hip replacement in avascular femoral head necrosis

Abstract

Background

Avascular necrosis of the femoral head is a progressive perfusion disorder of the hip joint. Progress in avascular necrosis causes structural damage to the affected joint, often requiring total hip replacement.

Aim

This article is intended to give the reader an overview of the current literature on total hip replacement of patients with an avascular necrosis of the femoral head.

Results

Before 1990, patients with avascular necrosis of the femoral head had significantly higher revision rates after total hip replacement. Recent studies, however, showed no significant differences in clinical outcomes after total hip replacement in femoral head necrosis and primary osteoarthritis.

Summary

Despite the young age of the patients, good long-term clinical results can be expected even in patients with an avascular necrosis of the femoral head after total hip replacement.

Keywords

Coxa Coxarthrosis Joint replacement Osteoarthrosis Young adult 

Notes

Einhaltung ethischer Richtlinien

Interessenkonflikt

M. Betsch, M. Tingart, A. Driessen, V. Quack und B. Rath geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

Literatur

  1. 1.
    Abe T, Kaku N, Tabata T et al (2017) Clinical results of hemiarthroplasty using new bipolar cups for stage 3 or lower osteonecrosis of the femoral head: a retrospective study. Musculoskelet Surg.  https://doi.org/10.1007/s12306-017-0524-6 PubMedCrossRefGoogle Scholar
  2. 2.
    Beckmann J, Rader C, Lürung C, Rath B, Grifka J, Tingart M (2010) Endoprosthesis in femoral head necrosis. Osteologie 19:46–52CrossRefGoogle Scholar
  3. 3.
    Beckmann J, Schmidt T, Schaumburger J et al (2013) Infusion, core decompression, or infusion following core decompression in the treatment of bone edema syndrome and early avascular osteonecrosis of the femoral head. Rheumatol Int 33:1561–1565CrossRefPubMedGoogle Scholar
  4. 4.
    Bedard NA, Callaghan JJ, Liu SS et al (2013) Cementless THA for the treatment of osteonecrosis at 10-year follow-up: have we improved compared to cemented THA? J Arthroplasty 28:1192–1199CrossRefPubMedGoogle Scholar
  5. 5.
    Berend KR, Gunneson E, Urbaniak JR et al (2003) Hip arthroplasty after failed free vascularized fibular grafting for osteonecrosis in young patients. J Arthroplasty 18:411–419CrossRefPubMedGoogle Scholar
  6. 6.
    Bizot P, Banallec L, Sedel L et al (2000) Alumina-on-alumina total hip prostheses in patients 40 years of age or younger. Clin Orthop Relat Res 379:68–76CrossRefGoogle Scholar
  7. 7.
    Capone A, Bienati F, Torchia S et al (2017) Short stem total hip arthroplasty for osteonecrosis of the femoral head in patients 60 years or younger: a 3- to 10-year follow-up study. BMC Musculoskelet Disord 18:301CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Chiu KH, Shen WY, Ko CK et al (1997) Osteonecrosis of the femoral head treated with cementless total hip arthroplasty. A comparison with other diagnoses. J Arthroplasty 12:683–688CrossRefPubMedGoogle Scholar
  9. 9.
    Colomb-Lippa D (2014) Avascular necrosis of the femoral head. JAAPA 27:40–41PubMedGoogle Scholar
  10. 10.
    Cornell CN, Salvati EA, Pellicci PM (1985) Long-term follow-up of total hip replacement in patients with osteonecrosis. Orthop Clin North Am 16:757–769PubMedGoogle Scholar
  11. 11.
    D’antonio J, Capello W, Manley M et al (2005) Alumina ceramic bearings for total hip arthroplasty: five-year results of a prospective randomized study. Clin Orthop Relat Res 436:164–171CrossRefGoogle Scholar
  12. 12.
    D’antonio JA, Capello WN, Manley MT et al (1997) Hydroxyapatite coated implants. Total hip arthroplasty in the young patient and patients with avascular necrosis. Clin Orthop Relat Res 344:124–138CrossRefGoogle Scholar
  13. 13.
    Dastane MR, Long WT, Wan Z et al (2008) Metal-on-metal hip arthroplasty does equally well in osteonecrosis and osteoarthritis. Clin Orthop Relat Res 466:1148–1153CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Dong N, Yang C, Li SQ et al (2016) Effect of preoperative leg length discrepancy on functional outcome and patient satisfaction after total hip arthroplasty in cases of osteonecrosis of the femoral head. J Arthroplasty 31:2789–2794CrossRefPubMedGoogle Scholar
  15. 15.
    Drescher W, Pufe T, Smeets R et al (2011) Avascular necrosis of the hip—diagnosis and treatment. Z Orthop Unfall 149:231–240 (quiz 241–232)CrossRefPubMedGoogle Scholar
  16. 16.
    Fehrle MJ, Callaghan JJ, Clark CR et al (1993) Uncemented total hip arthroplasty in patients with aseptic necrosis of the femoral head and previous bone grafting. J Arthroplasty 8:1–6CrossRefPubMedGoogle Scholar
  17. 17.
    Fink B, Ruther W (2000) Partial and total joint replacement in femur head necrosis. Orthopäde 29:449–456PubMedGoogle Scholar
  18. 18.
    Floerkemeier T, Budde S, Gronewold J et al (2015) Short-stem hip arthroplasty in osteonecrosis of the femoral head. Arch Orthop Trauma Surg 135:715–722CrossRefPubMedGoogle Scholar
  19. 19.
    Floerkemeier T, Tscheuschner N, Calliess T et al (2012) Cementless short stem hip arthroplasty METHA(R) as an encouraging option in adults with osteonecrosis of the femoral head. Arch Orthop Trauma Surg 132:1125–1131CrossRefPubMedGoogle Scholar
  20. 20.
    Gao YH, Li SQ, Wang YF et al (2015) Arthroplasty in patients with extensive femoral head avascular necrosis: cementless arthroplasty in extensive femoral head necrosis. Int Orthop 39:1507–1511CrossRefPubMedGoogle Scholar
  21. 21.
    Han SI, Lee JH, Kim JW et al (2013) Long-term durability of the CLS femoral prosthesis in patients with osteonecrosis of the femoral head. J Arthroplasty 28:828–831CrossRefPubMedGoogle Scholar
  22. 22.
    Johannson HR, Zywiel MG, Marker DR et al (2011) Osteonecrosis is not a predictor of poor outcomes in primary total hip arthroplasty: a systematic literature review. Int Orthop 35:465–473CrossRefPubMedGoogle Scholar
  23. 23.
    Kim YH, Kim JS, Park JW et al (2011) Contemporary total hip arthroplasty with and without cement in patients with osteonecrosis of the femoral head: a concise follow-up, at an average of seventeen years, of a previous report. J Bone Joint Surg Am 93:1806–1810CrossRefPubMedGoogle Scholar
  24. 24.
    Kim YH, Oh SH, Kim JS et al (2003) Contemporary total hip arthroplasty with and without cement in patients with osteonecrosis of the femoral head. J Bone Joint Surg Am 85-A:675–681CrossRefPubMedGoogle Scholar
  25. 25.
    Larson E, Jones LC, Goodman SB et al (2018) Early-stage osteonecrosis of the femoral head: where are we and where are we going in year 2018? Int Orthop 42:1723–1728CrossRefPubMedGoogle Scholar
  26. 26.
    Lee SB, Sugano N, Nakata K et al (2004) Comparison between bipolar hemiarthroplasty and THA for osteonecrosis of the femoral head. Clin Orthop Relat Res 424:161–165CrossRefGoogle Scholar
  27. 27.
    Lim SJ, Moon YW, Eun SS et al (2008) Total hip arthroplasty using the S‑ROM modular stem after joint-preserving procedures for osteonecrosis of the femoral head. J Arthroplasty 23:495–501CrossRefPubMedGoogle Scholar
  28. 28.
    Merschin D, Hane R, Tohidnezhad M et al (2018) Bone-preserving total hip arthroplasty in avascular necrosis of the hip—a matched-pairs analysis. Int Orthop 42:1509–1516CrossRefPubMedGoogle Scholar
  29. 29.
    Miladi M, Villain B, Mebtouche N et al (2018) Interest of short implants in hip arthroplasty for osteonecrosis of the femoral head: comparative study “uncemented short” vs “cemented conventional” femoral stems. Int Orthop.  https://doi.org/10.1007/s00264-018-3981-0 PubMedCrossRefGoogle Scholar
  30. 30.
    Millar NL, Halai M, Mckenna R et al (2010) Uncemented ceramic-on-ceramic THA in adults with osteonecrosis of the femoral head. Orthopedics 33:795PubMedGoogle Scholar
  31. 31.
    Mont MA, Seyler TM, Marker DR et al (2006) Use of metal-on-metal total hip resurfacing for the treatment of osteonecrosis of the femoral head. J Bone Joint Surg Am 88(Suppl 3):90–97PubMedGoogle Scholar
  32. 32.
    Mont MA, Seyler TM, Plate JF et al (2006) Uncemented total hip arthroplasty in young adults with osteonecrosis of the femoral head: a comparative study. J Bone Joint Surg Am 88(Suppl 3):104–109PubMedGoogle Scholar
  33. 33.
    Moya-Angeler J, Gianakos AL, Villa JC et al (2015) Current concepts on osteonecrosis of the femoral head. World J Orthop 6:590–601CrossRefPubMedPubMedCentralGoogle Scholar
  34. 34.
    Nich C, El Sariali H, Hannouche D et al (2003) Long-term results of alumina-on-alumina hip arthroplasty for osteonecrosis. Clin Orthop Relat Res 417:102–111Google Scholar
  35. 35.
    Ortiguera CJ, Pulliam IT, Cabanela ME (1999) Total hip arthroplasty for osteonecrosis: matched-pair analysis of 188 hips with long-term follow-up. J Arthroplasty 14:21–28CrossRefPubMedGoogle Scholar
  36. 36.
    Osawa Y, Seki T, Morita D et al (2017) Total hip arthroplasty after transtrochanteric rotational osteotomy for osteonecrosis of the femoral head: a mean 10-year follow-up. J Arthroplasty 32:3088–3092CrossRefPubMedGoogle Scholar
  37. 37.
    Osawa Y, Seki T, Takegami Y et al (2018) Cementless total hip arthroplasty for osteonecrosis and osteoarthritis produce similar results at ten years follow-up when matched for age and gender. Int Orthop 42:1683–1688CrossRefPubMedGoogle Scholar
  38. 38.
    Papakostidis C, Tosounidis TH, Jones E et al (2016) The role of “cell therapy” in osteonecrosis of the femoral head. A systematic review of the literature and meta-analysis of 7 studies. Acta Orthop 87:72–78CrossRefPubMedGoogle Scholar
  39. 39.
    Park KS, Tumin M, Peni I et al (2014) Conversion total hip arthroplasty after previous transtrochanteric rotational osteotomy for osteonecrosis of the femoral head. J Arthroplasty 29:813–816CrossRefPubMedGoogle Scholar
  40. 40.
    Pepke W, Kasten P, Beckmann NA et al (2016) Core decompression and autologous bone marrow concentrate for treatment of femoral head osteonecrosis: a randomized prospective study. Orthop Rev (Pavia) 8:6162CrossRefGoogle Scholar
  41. 41.
    Pierce TP, Elmallah RK, Jauregui JJ et al (2015) Outcomes of total hip arthroplasty in patients with osteonecrosis of the femoral head—a current review. Curr Rev Musculoskelet Med 8:246–251CrossRefPubMedPubMedCentralGoogle Scholar
  42. 42.
    Quack V, Betsch M, Schenker H et al (2015) Pathophysiology of traumatic bone marrow edema. Unfallchirurg 118:199–205CrossRefPubMedGoogle Scholar
  43. 43.
    Radl R, Hungerford M, Materna W et al (2005) Higher failure rate and stem migration of an uncemented femoral component in patients with femoral head osteonecrosis than in patients with osteoarthrosis. Acta Orthop 76:49–55CrossRefPubMedGoogle Scholar
  44. 44.
    Roth A, Beckmann J, Bohndorf K et al (2016) S3-guideline non-traumatic adult femoral head necrosis. Arch Orthop Trauma Surg 136:165–174CrossRefPubMedGoogle Scholar
  45. 45.
    Saito S, Saito M, Nishina T et al (1989) Long-term results of total hip arthroplasty for osteonecrosis of the femoral head. A comparison with osteoarthritis. Clin Orthop Relat Res 244:198–207Google Scholar
  46. 46.
    Schneider W, Breitenseher M, Engel A et al (2000) The value of core decompression in treatment of femur head necrosis. Orthopäde 29:420–429PubMedGoogle Scholar
  47. 47.
    Schnurr C, Loucif A, Patzer T et al (2018) Short stem survival after osteonecrosis of the femoral head. Arch Orthop Trauma Surg 138:573–579CrossRefPubMedGoogle Scholar
  48. 48.
    Seyler TM, Bonutti PM, Shen J et al (2006) Use of an alumina-on-alumina bearing system in total hip arthroplasty for osteonecrosis of the hip. J Bone Joint Surg Am 88(Suppl 3):116–125PubMedGoogle Scholar
  49. 49.
    Smith SW, Fehring TK, Griffin WL et al (1995) Core decompression of the osteonecrotic femoral head. J Bone Joint Surg Am 77:674–680CrossRefPubMedGoogle Scholar
  50. 50.
    Steinberg ME, Corces A, Fallon M (1999) Acetabular involvement in osteonecrosis of the femoral head. J Bone Joint Surg Am 81:60–65CrossRefPubMedGoogle Scholar
  51. 51.
    Stulberg BN, Fitts SM, Zadzilka JD et al (2009) Resurfacing arthroplasty for patients with osteonecrosis. Bull Nyu Hosp Jt Dis 67:138–141PubMedGoogle Scholar
  52. 52.
    Xenakis TA, Gelalis J, Koukoubis TA et al (2001) Cementless hip arthroplasty in the treatment of patients with femoral head necrosis. Clin Orthop Relat Res 386:93–99CrossRefGoogle Scholar
  53. 53.
    Zeh A, Weise A, Vasarhelyi A et al (2011) Medium-term results of the Mayo short-stem hip prosthesis after avascular necrosis of the femoral head. Z Orthop Unfall 149:200–205CrossRefPubMedGoogle Scholar

Copyright information

© Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2018

Authors and Affiliations

  • M. Betsch
    • 1
  • M. Tingart
    • 1
  • A. Driessen
    • 1
  • V. Quack
    • 1
  • B. Rath
    • 1
  1. 1.Klinik für OrthopädieUniklinik RWTH AachenAachenDeutschland

Personalised recommendations