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Physiologische Reaktionen im Interface zementfreier Implantate

Physiological reactions in the interface between cementless implants and bone

  • Leitthema
  • Published:
Die Orthopädie Aims and scope Submit manuscript

Zusammenfassung

Hintergrund

Der Stellenwert der operativen Therapie von Patienten mit konservativ-therapierefraktärer Koxarthrose gewinnt bei einer alternden Bevölkerung mit steigendem Funktionsanspruch weiterhin zunehmend an Bedeutung.

Fragestellung

Was sind die physiologischen Reaktionen im Interface zwischen zementfreiem Implantat und Knochen?

Material und Methoden

Aufarbeitung von Grundlagenarbeiten, Expertenempfehlungen und Tiermodellen.

Ergebnisse

Implantatspezifische Oberflächenbeschichtungen aus Hydroxylapatit oder Titan können positive Effekte auf die Osteointegration haben. Die zusätzliche topische Applikation von Mediatoren kann die Osteointegration zukünftig positiv beeinflussen.

Schlussfolgerung

Die kurzfristige periimplantäre Knochenheilung nach Implantation, bzw. eine physiologische Knochenremodellierung der Knochen-Implantat-Grenzfläche sind entscheidend für die Sekundärstabilität des Implantates.

Abstract

Background

Surgical treatment of patients with osteoarthritis of the hip and persisting symptoms under conservative therapy has become increasingly important against the background of an aging population.

Objectives

What are the physiological reactions in the interface between cementless implants and bone?

Methods

The literature is reviewed, expert opinions and animal models are analyzed and discussed.

Results

Surface coating of implants with hydroxyapatite or titanium can have positive effects on osteointegration. Additional local application of mediators might be beneficial for osteointegration in the future.

Conclusion

Early peri-implant bone healing directly after implantation and late remodeling of the bone–implant interface are essential for secondary implant stability.

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Abb. 1

Abbreviations

BMP:

„Bone morphogenic protein“

GDF :

„Growth-and-differentiation“-Faktoren

HA :

Hydroxylapatit

M1 :

Proinflammatorische Makrophagen

M2 :

Antiinflammatorische Makrophagen

TGF :

„Tissue growth factor“

VEGF :

„Vascular endothelial growth factor“

XLPE :

„Cross-linked polyethylene“

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  1. Klinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Bonn, Venusberg-Campus 1, 53127, Bonn, Deutschland

    Frank Sebastian Fröschen, Dieter Christian Wirtz & Frank Alexander Schildberg

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  1. Frank Sebastian Fröschen
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Correspondence to Frank Sebastian Fröschen.

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Fröschen, F.S., Wirtz, D.C. & Schildberg, F.A. Physiologische Reaktionen im Interface zementfreier Implantate. Orthopädie 52, 178–185 (2023). https://doi.org/10.1007/s00132-023-04347-9

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