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Knietotalendoprothesenwechsel bei periprothetischen Frakturen

Total knee endoprosthesis revision following periprosthetic fractures

  • Leitthema
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Trauma und Berufskrankheit

Zusammenfassung

Periprothetische Frakturen bei Knieendoprothesen können intra- oder postoperativ auftreten. Ihre Behandlung hängt von ihrer Stabilität, ihrer Lokalisation und der Knochenqualität ab. Entscheidender Parameter für das operative Vorgehen ist die Stabilität des Implantats. Im Gegensatz zur Hüftendoprothetik ist diese meist gegeben, sodass die Osteosynthese das Mittel der Wahl darstellt. Bei instabilem Implantat stellt sich die Indikation zum Implantatwechsel mit Schaftverlängerung und Überbrückung der Fraktur. Bei defizitären Knochen kommen Tumorprothesen zur Anwendung. Im vorliegenden Beitrag werden Indikation, Techniken und Ergebnisse der Versorgung periprothetischer Frakturen bei Knieendoprothesen beschrieben.

Abstract

Periprosthetic fractures associated with total knee arthroplasty may occur intraoperatively or postoperatively. Therapy depends on the stability of the fracture, the location of the fracture and bone quality. The parameter that determines the surgical treatment is the stability of the implant. In contrast to periprosthetic fractures associated with total hip arthroplasty the implant is stable in the majority of cases, so internal fixation is the therapy of choice. If the fracture is associated with an unstable implant, then a revision with a stemmed component and bridging of the fracture must be performed. In cases with deficient bone stock, tumor prostheses may be necessary. In this paper the indication, technique and results are described.

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Hube, R., Mayr, H. Knietotalendoprothesenwechsel bei periprothetischen Frakturen. Trauma Berufskrankh 14, 184–189 (2012). https://doi.org/10.1007/s10039-012-1899-0

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