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Fixationstechniken bei periazetabulärer Osteotomie

Stabilität und klinische Aspekte etablierter und neuer Fixationstechniken

Fixation techniques in periacetabular osteotomy

Stability and clinical aspects of established and new fixation techniques

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Zusammenfassung

Die periazetabuläre Osteotomie nach Ganz (PAO) ist eine etablierte Technik zur operativen Therapie der Hüftgelenksdysplasie mit dem Ziel, das dysplastische Hüftgelenk biomechanisch zu optimieren. Durch die mehrdimensionale Reorientierung soll die defizitäre Überdachung des Hüftkopfes verbessert und physiologische Werte erreicht werden. Bis zur knöchernen Konsolidierung ist eine adäquate Fixierung des Azetabulums in der erreichten Korrekturposition notwendig. Dazu stehen unterschiedliche Fixationstechniken zur Verfügung. Neben Schrauben können auch Kirschner-Drähte zur Fixierung eingesetzt werden. Die unterschiedlichen Fixationstechniken zeigen eine vergleichbare Stabilität. Unterschiede bestehen bei dem Auftreten implantatassoziierter Komplikationen. Jedoch besteht kein Unterschied hinsichtlich der Patientenzufriedenheit und gelenkspezifischer Funktion.

Abstract

Periacetabular osteotomy according to Ganz (PAO) is an established technique for the surgical treatment of hip dysplasia with the aim of biomechanically optimizing the dysplastic hip joint. Through multidimensional reorientation, the deficient coverage of the femoral head can be improved and physiological values can be achieved. Until bony consolidation is reached, adequate fixation of the acetabulum in the corrected position achieved is necessary. Various fixation techniques are available for this purpose. Alternatively to screws, Kirschner wires can also be used for fixation. The different fixation techniques show comparable stability. Differences exist in the occurrence of implant-associated complications. However, there is no difference in patient satisfaction and joint-specific function.

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Change history

  • 20 March 2023

    Der Untertitel des Beitrags wurde korrigiert.

Abbreviations

mHHS:

modifizierter Harris Hip Score

PAO :

Periazetabuläre Osteotomie

SIAS :

Spina iliaca anterior superior

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Authors and Affiliations

  1. Centrum für Muskuloskeletale Chirurgie, Charité – Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Deutschland

    Vincent Justus Leopold, Carsten Perka & Sebastian Hardt

Authors
  1. Vincent Justus Leopold
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  2. Carsten Perka
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  3. Sebastian Hardt
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Correspondence to Vincent Justus Leopold.

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Interessenkonflikt

V.J. Leopold, C. Perka und S. Hardt geben an, dass kein Interessenkonflikt besteht.

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

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Leopold, V.J., Perka, C. & Hardt, S. Fixationstechniken bei periazetabulärer Osteotomie. Orthopädie 52, 293–299 (2023). https://doi.org/10.1007/s00132-023-04355-9

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