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Fallstricke bei endoprothetischen Wechseleingriffen

Pitfalls in revision hip arthroplasty

Zusammenfassung

Die Eckpunkte für eine erfolgreiche Revisionsendoprothetik sind Identifikation der Implantate, präoperative klinische Diagnostik, Planung (einschließlich Alternativen) und Strategie, Weichteilmanagement, Auswahl der Revisionsimplantate und Bereitstellung von speziellen Instrumentarien, die sichere Fixation der azetabulären und femoralen Komponenten sowie abschließend die Herstellung stabiler Gelenkverhältnisse ohne Risiko für Luxation oder Impingement. Bei der Analyse von Komplikationen fällt immer wieder auf, wie sehr Probleme bei richtiger perioperativer Entscheidungsfindung vermeidbar gewesen wären. Tipps und Tricks für die Revisionsendoprothetik werden im nachfolgend dargestellt.

Abstract

Significant key points for a successful revision surgery in hip arthroplasty are as follows: identification of the implants, preoperative clinical diagnoses, planning (including alternatives) as well as establishing a surgical strategy, selection of revision implants and provision with special tools, secure fixation of acetabular and femoral components and the reconstruction of a stable joint without risk of dislocation or impingement. It seems to be obvious that most problems can be avoided by clear and concise decision-making. Some tips and tricks are also presented.

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Abbreviations

BfArM:

Bundesinstitut für Arzneimittel und Medizinprodukte

BMI :

Body-Mass-Index

CCD-Winkel :

Centrum-Collum-Diaphysen-Winkel

MGM :

Material, Größen und Maße

PE :

Polyethylen

PMMA :

Polymethylmethacrylat

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Correspondence to Carsten Perka or Rudolf Ascherl.

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Interessenkonflikt

C. Perka ist Berater der Firmen DePuY/Synthes, Link und Zimmer. R. Ascherl gibt an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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Perka, C., Ascherl, R. Fallstricke bei endoprothetischen Wechseleingriffen. Orthopädie (2022). https://doi.org/10.1007/s00132-022-04282-1

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  • DOI: https://doi.org/10.1007/s00132-022-04282-1

Schlüsselwörter

  • Komplikationen
  • Hüftrevisionsendoprothetik
  • Technische Tipps
  • Hüftchirurgie
  • Hüftgelenksersatz

Keywords

  • Complications
  • Hip revision arthroplasty
  • Technical tipps
  • Hip surgery
  • Total hip replacement