Skip to main content

Advertisement

Log in

Frühfunktionelle Ergebnisse einer Kurzschaftprothese des Hüftgelenks mit metaphysär-intertrochantärer Verankerung

Early functional results with the Mayo-hip, a short stem system with metaphyseal-intertrochanteric fixation

  • Leitthema
  • Published:
Der Orthopäde Aims and scope Submit manuscript

Zusammenfassung

Die Hüftendoprothetik hat sich zu einem der erfolgreichsten Standardverfahren in der orthopädischen Chirurgie entwickelt. Durch die Implantation bei immer jüngeren Patienten gewinnt die knochensparende Implantation von Prothesen zunehmende Bedeutung, um im Falle eines Prothesenwechsels eine bestmögliche ossäre Situation zu erreichen. Ein Vertreter dieser konservativen Implantate ist der Mayo-Schaft, für den bereits Langzeitresultate vorliegen. Die Verankerung der Prothese im Bereich des lateralen Schenkelhalses wird durch ein Multi-Punkt-Prinzip erreicht. Das System zeichnet sich durch seine Einfachheit in der operativen Technik aus. Durch die weit mediale Präparation des Schenkelhalses wird bei transglutealem Zugang die Irritation der Abduktoren vermindert. In einer prospektiv-randomisierten Studie wurden mit dem Mayo-Kurzschaft signifikant bessere frühfunktionelle Ergebnisse erreicht als mit einem zementfreien Standardschaft. Der Mayo-Schaft ist nicht für jede Hüftsituation zu verwenden, trägt aber bei richtiger Indikation erheblich zum Erhalt autogener Knochensubstanz bei und ist somit eine sinnvolle Alternative zu konventionellen Schaftsystemen.

Abstract

Total hip arthroplasty has become one of the most successful standard procedures in orthopedic surgery. With a more frequent use in young and active patients bone saving procedures become more important. The goal is to save good bone stock for the revision procedure.

One example of conservative femoral implants is the Mayo-stem with reported long term results. The stem design allows a metaphyseal intertrochanteric multipoint fixation for primary fixation. The surgical technique is simple. Using a transgluteal approach, the medial preparation of the femoral neck decreases significantly the irritation of the abductor tendons. In a prospective-randomized study, the early functional results with the Mayo-stem were significantly better than the results achieved with a cement-free standard stem. The Mayo-stem may not be indicated for every hip situation. Its use, however, in cases with normal anatomy contributes to save autologeous bone. Therefore, this short stem is a sensible alternative to standard stems.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Abb. 1a, b
Abb. 2
Abb. 3
Abb. 4
Abb. 5
Abb. 6a, b
Abb. 7
Abb. 8
Abb. 9
Abb. 10

Literatur

  1. Adili A, Trousdale RT (2003) Femoral head resurfacing for the treatment of osteonecrosis in the young patient. Clin Orthop 417: 93–101

    PubMed  Google Scholar 

  2. Barber TC, Roger DJ, Goodman SB, Schurman DJ (1996) Early outcome of total hip arthroplasty using the direct lateral vs the posterior surgical approach. Orthopedics 19: 873–875

    CAS  PubMed  Google Scholar 

  3. Bauer R, Kerschbaumer F, Poisel S (1994) Orthopädische Operationslehre in drei Bänden. Bd. 2. Becken und untere Extremität. Thieme, Stuttgart New York

  4. Berry DJ, Morrey BF (1996) Uncemented femoral components. In: Morrey BF (ed) Reconstructive surgery of the joints, 2nd edn. Churchill Livingston, New York

  5. Boeree NR, Bannister GC (1993) Cemented total hip arthroplasty in patients younger than 50 years of age. Ten to 18-year results. Clin Orthop 287: 153–159

    PubMed  Google Scholar 

  6. Callaghan JJ, Dasart SH, Savory CG (1988) The uncemented porous-coated anatomic total hip prosthesis: two year results of a prospective consecutive series. J Bone Joint Surg Am 70: 337–346

    CAS  PubMed  Google Scholar 

  7. Cook SD, Klawitter JJ, Weinstein AM (1980) The influence of design parameters on calcar stresses following femoral head arthroplasty. J Biomed Mater Res 14: 133–144

    CAS  PubMed  Google Scholar 

  8. Decker T, Krüger T, Reichel H (2003) 10-Jahres-Ergebnisse nach Implantation von ABG-Prothesen: Eine prospektive Studie. Deutscher Orthopädenkongress, Vortrag K 20–4, Berlin, 13.–16.11.2003

  9. Engh CA, Bobyn JD, Glassman AH (1987) Porous-coated hip replacement: the factors governing bone ingrowth, stress shielding and clinical results. J Bone Joint Surg Br 69: 45–55

    CAS  PubMed  Google Scholar 

  10. Gruen TA, McNeice GM, Amstutz HC (1979) Modes of failure of cemented stem-type femoral components: a radiographic analysis of loosening. Clin Orthop 141: 17–27

    PubMed  Google Scholar 

  11. Harris WH (1969) Traumatic arthritis of the hip after dislocation and acetbular fractures: treatment ba mold arthroplasty. An end-result study using a new method of result evaluation. J Bone Joint Surg Am 51: 737–755

    CAS  PubMed  Google Scholar 

  12. Hube R, Hein W (2002) Die Mayo-Hüfte—eine neue Philosophie zur proximalen Femurverankerung. In: Perka C, Zippel H (Hrsg) Trends und Kontroversen in der Endoprothetik des Hüftgelenkes. Einhorn, Reinbek, S 86–90

  13. Huggler AH, Jacob HAC (1980) A new approach towards hip prosthesis design. Arch Orthop Trauma Surg 98: 165–171

    Google Scholar 

  14. Huggler AH, Jacob HAC, Bereiter H et al. (1993) Long-term results with the uncemented thrust plate prosthesis. Acta Orthop Belg 59 [Suppl 1]: 215–223

    PubMed  Google Scholar 

  15. Jasty M, Krushell R, Zalenski E et al. (1993) The contribution of the nonporous distal stem to the stability of proximally porous-coated canine femoral components. J Arthroplasty 8: 33–41

    CAS  PubMed  Google Scholar 

  16. Kuiper JH, Huiskes R (1996) Friction and stem stiffness affect dynamic interface motion in total hip replacement. J Orthop Res 14: 36–43

    CAS  PubMed  Google Scholar 

  17. Lachiewicz PF, Anspach WE, DeMasi RAA (1992) Prospective study of 100 consecutive Harris-Galante porous total hip arthroplasties: 2–5 year results. J Arthroplasty 7: 519–526

    CAS  PubMed  Google Scholar 

  18. Lieberman JR, Dorey F, Shekelle P et al. (1997) Outcome after total hip arthroplasty. Comparison of traditional disease-specific and a quality of life measurement outcome. J Arthroplasty 12: 639–645

    Article  CAS  PubMed  Google Scholar 

  19. Malchau H, Herberts P (2000) Prognosis of total hip replacement—update and validation of results from the Swedish National Hip Arthroplasty Register 1979–1998. 65th Annual Meeting of the AAOS, March 15–19, Orlando, USA

  20. Mallory TH, Head WC, Lombardi AV et al. (1996) Clinical and radiographic outcome of cementless titanium, plasma spray-coated total hip arthroplasty femoral component: justification for continuance of use. J Arthroplasty 11: 653–660

    CAS  PubMed  Google Scholar 

  21. McMinn D, Treacy R, Lin K et al. (1996) Metal on metal surface replacement of the hip. Clin Orthop 329: 89–98

    Article  Google Scholar 

  22. Morrey BF (1989) Short-stemmed uncemented femoral component for primary hip arthroplasty. Clin Orthop 249: 169–175

    PubMed  Google Scholar 

  23. Morrey BF, Adams RA, Kessler M (2000) A conservative femoral replacement for total hip arthroplasty. J Bone Joint Surg Br 82: 952–958

    Article  CAS  PubMed  Google Scholar 

  24. Munting E, Smitz P, Van Sante N et al. (1997) Effect of a stemless femoral implant for total hip arthroplasty on the bone mineral density of the proximal femur: a prospective longitudinal study. J Arthroplasty 12: 373–379

    Article  CAS  PubMed  Google Scholar 

  25. Nunn D, Freeman MA, Hill PF, Evans SJ (1989) The measurement of migration of the acetabular component of hip prostheses. J Bone Joint Surg Br 71: 629–631

    CAS  PubMed  Google Scholar 

  26. Ranawat CS, Dorr LD, Inglis AE (1980) Total hip arthroplasty in protrusio acetabuli of rheumatoid arthritis. J Bone Joint Surg Am 62: 1059–1065

    CAS  PubMed  Google Scholar 

  27. Schmalzried TP, Fowble VA, Ure KJ, Amstutz HC (1996) Metal on metal surface replacement of the hip. Technique, fixation, and early results. 329: 106–114

  28. Wetherell RG, Amis AA, Heatley FW (1989) Measurement of acetabular erosion. The effect of pelvic rotation on common landmarks. J Bone Joint Surg Br 71: 447–451

    CAS  PubMed  Google Scholar 

  29. Wolff J (1892) Das Gesetz der Transformation der Knochen. Reprint: Wessinghage D: Reprints medizinhistorischer Schriften. Schattauer, Stuttgart

  30. Woolson ST, Maloney WJ (1992) Cementless total hip arthroplasty using a porous-coated prosthesis for bone ingrowth fixation. J Arthroplasty 7: 381–388

    PubMed  Google Scholar 

Download references

Interessenkonflikt:

Der korrespondierende Autor versichert, dass keine Verbindungen mit einer Firma, deren Produkt in dem Artikel genannt ist, oder einer Firma, die ein Konkurrenzprodukt vertreibt, bestehen.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to R. Hube.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Hube, R., Zaage, M., Hein, W. et al. Frühfunktionelle Ergebnisse einer Kurzschaftprothese des Hüftgelenks mit metaphysär-intertrochantärer Verankerung. Orthopäde 33, 1249–1258 (2004). https://doi.org/10.1007/s00132-004-0711-7

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00132-004-0711-7

Schlüsselwörter

Keywords

Navigation