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Rehabilitation und Sport nach Hüfttotalendoprothese

Rehabilitation and sport following total hip replacement

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Zusammenfassung

Die Zahl der Hüfttotalendoprothesenimplantationen in Deutschland steigt in den letzten Jahren deutlich an, wobei gleichzeitig die Patienten immer jünger werden. Deshalb stellt sich zunehmend die Frage nach den Faktoren, welche die Haltbarkeit einer Prothese beeinflussen, die in der Regel mit 15–20 Jahren angegeben wird. Ungünstig für die Haltbarkeit sind anscheinend weibliches Geschlecht, Übergewicht, jugendliches Alter und rheumatoide Arthritis oder Frakturen als Operationsindikation. Eine möglichst frühe Rehabilitationsbehandlung wirkt sich günstig auf die Gelenkfunktion aus. Im weiteren Verlauf sollte medizinische Trainingstherapie zum Einsatz kommen. Am Anfang der Rehabilitation steht neben der Luxationsprophylaxe mit Training der hüftumgreifenden Muskulatur die Gangschule im Vordergrund. Zur Frage, wie sich Sport auf die Haltbarkeit einer Hüftprothese auswirkt, bestehen unterschiedliche Meinungen. Gesichert scheint jedoch, dass sich sportliche Betätigung insgesamt positiv auswirkt und nicht zwangsläufig höhere Lockerungsraten mit sich bringt. Bei der Wahl der Sportarten sollten High-impact-Sportarten vermieden werden. Besonders geeignet scheinen Radfahren, Schwimmen und Wassergymnastik, Wandern, Rudern und Tanzen.

Abstract

The number of total hip replacement (THR) surgeries has increased significantly over the last few years and patients undergoing surgery are of decreasing age. In consequence the question of the influencing factors for the survival of artificial hip joints becomes more and more urgent. The expected survival time of an implant is nowadays 15–20 years and it seems that factors for a shorter lifetime are female gender, overweight, younger age and certain indications which led to surgery, such as rheumatoid arthritis or fractures. In the early phase of rehabilitation, measures against dislocation including training of the abductor muscles are most important. Starting rehabilitation programs early after surgery has positive effects on outcome, especially when strengthening programs are included. There are different opinions concerning the question how the lifetime of a THR is influenced by sports activities. However, it seems to have been demonstrated that suitable sports activities have a positive effect and do not necessarily correlate with higher loosening rates after THR. In general, high-impact sports should be avoided. Recommended activities are cycling, swimming, aquajogging, hiking, rowing and dancing.

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Authors and Affiliations

  1. MedicalPark Chiemsee, Bernau-Felden, Birkenallee 41, 83253, Bernau-Felden, Deutschland

    M. Schmitt-Sody & V. Pilger

  2. Klinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Schleswig Holstein, Campus Kiel, Kiel, Deutschland

    L. Gerdesmeyer

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  1. M. Schmitt-Sody
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  2. V. Pilger
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  3. L. Gerdesmeyer
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Correspondence to M. Schmitt-Sody.

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Schmitt-Sody, M., Pilger, V. & Gerdesmeyer, L. Rehabilitation und Sport nach Hüfttotalendoprothese. Orthopäde 40, 513–519 (2011). https://doi.org/10.1007/s00132-011-1761-2

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