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Herkömmliche vs. minimal-invasive Hüftendoprothetik

Eine prospektive Studie über Rehabilitation und Komplikationen

Conventional vs minimally invasive total hip arthroplasty

A prospective study of rehabilitation and complications

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Zusammenfassung

Hintergrund

In einer prospektiven, nicht randomisierten Studie wurden die Ergebnisse hinsichtlich Rehabilitation und Komplikationsrate von Hüftendoprothesen verglichen, welche entweder mittels einer gewebeschonenden Technik, der sog. superioren Kapsulotomie (Studiengruppe), oder eines konventionellen Zugangs, des direkten lateralen Zugangs (Kontrollgruppe), eingesetzt wurden.

Patienten und Methoden

Die Studiengruppe bestand aus 106 Patienten, die Kontrollgruppe aus 107 Patienten. Beide Gruppen zeigten keine Unterschiede bezüglich Alter, Geschlecht, Diagnose oder Body-Mass-Index (BMI).

Resultate

Die Studiengruppe zeigte eine statistisch signifikant akzelerierte Rehabilitation nach 6 Wochen (p<0,001) sowie eine niedrigere perioperative Komplikationsrate.

Schlussfolgerung

Die vorliegende Studie zeigt, dass weniger invasive chirurgische Techniken in der Hüftendoprothetik mit der Philosophie von größtmöglicher Schonung der Abduktorenmuskulatur, der posterioren Kapsel und der kleinen Außenrotatoren in einer sichereren Operation mit beschleunigter Rehabilitation resultieren können.

Abstract

Background

In a prospective, nonrandomized study the outcome in terms of rehabilitation and complications of total hip arthroplasty (THA) through a superior capsulotomy exposure (study group) was compared to THA performed through a direct lateral exposure (control group).

Patients and methods

The study group (106 THA) and the control group (107 THA) were controlled for complexity and had no significant differences in age, sex, diagnosis, or body mass index.

Results

The study group had improved recovery at 6 weeks after surgery which was statistically significant (p<0.001). In addition, the study group had a lower incidence of perioperative complications.

Conclusion

The current study demonstrates the potential that less-invasive surgical techniques with the philosophy of maximally preserving the abductors, posterior capsule, and short rotators may result in a safer operation with an accelerated recovery.

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Authors and Affiliations

  1. Klinik für Orthopädische Chirurgie, Inselspital, Universität Bern, Bern, Schweiz

    M. Tannast

  2. Orthopedic Surgery, Center for Computer Assisted and Reconstructive Surgery, Tufts University School of Medicine, Harvard Medical School, New England Baptist Hospital, 125 Parker Hill Avenue Suite 545, USA-02120 , Boston, USA, MA

    S. B. Murphy & M. Tannast

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  1. S. B. Murphy
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  2. M. Tannast
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M. Tannast wurde unterstützt durch ein Stipendium des Schweizerischen Nationalfonds (SNF).

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Murphy, S.B., Tannast, M. Herkömmliche vs. minimal-invasive Hüftendoprothetik. Orthopäde 35, 761–768 (2006). https://doi.org/10.1007/s00132-006-0969-z

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  • DOI: https://doi.org/10.1007/s00132-006-0969-z

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