Zusammenfassung
Periprothetische Frakturen nach dem Einbau von Knieprothesen stellen eine potentiell verheerende Komplikation für den Patienten und den Operateur dar. In der Literatur wird die Komplikationsraie selbst bei erfahrenen Operateuren mit 25–75% angegeben (Figgie et al. 1990; Merkel u. Johnson 1986), Zur Therapie dieser komplizierten Frakturen werden verschiedene Verfahren eingesetzt Häufigkeit, Pathogenese, Verletzungsmechanismen, Risikofaktoren und Behandlungsmöglichkeiten dieser Frakturen sollen in diesem Beitrag dargestellt werden.
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Literatur
Cain PR, Rubash HE, Wissinger HA, McClain EJ (1986) Peri- prosthetic femoral fractures following total knee arthroplasty. Clin Orthop 208:205–214
Chen F, Mont MA, Bachner RS (1994) Management of ipsilateral supracondylar femur fractures following total knee arthroplasty. J Arthroplasty 9:521–526
Culp RW, Schmidt RG, Hanks G et. al. (1987) Supracondylar fracture of the femur following prosthetic knee arthroplasty. Clin Orthop 222:212–222
Delport PH, Van Audekercke R, Martens M, Mulier JC (1984) Conservative treatment of ipsilateral supracondylar femoral fracture after total knee arthroplasty. J Trauma 24:846–849
Dennis DA (1999) Periprosthetic fractures folling total knee arthroplasty. J Trauma 24:846–849
Dennis DA (1998) Periprosthetic fractures folling total knee arthroplasty: The good, bad an ugly. Orthopedics 21:1048–1050
Figgie MP, Goldberg VN, Figgie HE, Sobel M (1990) The results of treatment of supracondylar fracture above total knee arthroplasty. J Arthroplasty 5:267–276
Harlow ML, Hofmann AA (1994) Periprosthetic fractures. In: Scott WN (ed) The Knee. Mosby, St. Louis, MO, pp 1405–1417
Hopf C, Hopf T, Rompe JD (1997) Fractures after total knee joint endoprosthesis. Results of treatment with various stabilizing methods. Unfallchirurgie 23:92–99
Lesh ML, Schneider DJ, Pellegrini VD (1998) Biomechanical evaluation of the effects of anterior cortical notehing of the femur in total knee arthroplasty. 65A Annual Meeting of the American Academy of Orthopaedic Surgeons, New Orleans
LA, March 19-23 Madsen F, Kjaersgaard-Andersen P, Juhl M, Sneppen O (1989) A custom-made prosthesis for the treatment of supracondylar femoral fractures after total knee arthroplasty: Report of four cases. J Orthop Trauma 3:333–337
McLaren AC, Dupont JA, Schroeber DC (1994) Open reduetion internal fixation of supracondylar fractures above total knee arthroplasties using the intramedullary supracondylar rod. Clin Orthop 302:194–198
Merkel KD, Johnson EW (1986) Supracondylar fracture of the femur after total knee arthroplasty. J Bone Jt Surg 68-A:29–43
Moran MC, Brick GW, Sledge CB, Dysart SH, Chien EP (1996) Supracondylar femoral fracture following total knee arthroplasty. Clin Orthop 324:196–209
Ritter MA, Faris PM, Keating EM (1988) Anterior femoral not ching and ipsilateral supracondylar femur fracture in total knee arthroplasty. J Arthroplasty 3:185–187
Ritter MA, Keating EM, Faris PM, Mending JB (1995) Rush rod fixation of supracondylar fractures above total knee arthroplasties. J Arthroplasty 10:213–216
Rolston LR, Christ DJ, Halpern A et. al. (1995) Treatment of supracondylar fractures of the femur proximal to a total knee arthroplasty. J Bone Jt Surg 77-A:924–931
Short WH, Hottnick DR., Murray DG (1981) Ipsilateral supracondylar femur fractures following knee arthroplasty. Clin Orthop 158:111–116
Sisto DJ, Lachiewicz PF, Insall JN (1985) Treatment of supra-condylar fractures following prosthetic arthroplasty of the knee. Clin Orthop 196:265–272
Zehntner MK, Ganz R (1993) Internal fixation of supracondylar fracture after condylar total knee arthroplasty. Clin Orthop 293:219–224
Achauer BM, Black KS, Litke DK (1980) Transcutaneous P02 in flaps: A new method of survival prediction. Plast Reconster Surg 65:738–745
Bengtson S, Carlsson A, Relander M et. al. (1987) Treatment of the exposed knee prosthesis. Acta Orthop Scand 58:662–666
Bridges SL Jr, Lopez Mendez A, Tracy I et. al. (1989) Should methotrexate be discontinued prior to total joint arthroplasty in rheumatoid arthritis patients? Arthritis Rheum 32 [Suppl 4]: 543
Craig SM (1987) Soft tissue considerations. In: Scott WN (ed) Total knee revision arthroplasty. Grüne & Stratton, Orlando, FL, pp 99–112
Dennis DA (1997a) Wound complications in total knee arthroplasty. Instr Course Lect 46:165–169
Dennis DA (1997b) Wound complications in total knee arthroplasty. Orthopedics 20:837–840
Ecker ML, Lotke PA (1989) Postoperative care of the total knee patient. Orthop Clin North Am 20:55–62
Ecker ML, Lotke PA (1993) Wound healing complications. In: Rand JA (ed) Total knee arthroplasty. Raven Press, New York, pp 403–407
Gerwin M, Rothaus KO, Windsor RE et. al. (1993) Gastrocnemius muscle Aap coverage of exposed or infected knee prostheses. Clin Orthop 286:64–70
Gold DA, Scott SC, Scott WN (1996) Soft tissue expansion prior to arthroplasty in the multiply-operated knee. A new method of preventing catastrophic skin problems. J Arthroplasty 11:512–21
Green JP (1965) Steroid therapy and wound healing in surgical patients. Br J Surg 52:523–525
Hallock GG (1990) Salväge of total knee arthroplasty with local fasciocutaneous flaps. J Bone Jt Surg 72-A:1236–1239
Johnson DP, Eastwood DM (1992) Lateral patellar release in knee arthroplasty: Effect on wound healing. J Arthroplasty 7 [Suppl]: 427–431
Johnson DP (1990) The effect of continuous passive motion on wound-healing and joint mobility after knee arthroplasty. J Bone Jt Surg 72-A:421–426
Klein NE, Cox CV (1994) Wound problems in total knee arthroplasty. In: Fu FH, Harner CD, Vince KG et. al. (eds) Knee surgery, vol 2. Williams & Wilkins, Baltimore, MD, pp 1539–1552
McGrath MH (1982) The effect of Prostaglandin inhibitors on wound contraction an the myofibroblast. Plast Reconstr Surg 69:74–85
Mosely LH, Finseth F, Goody M (1978) Nicotine and ist effect on wound healing. Plast Reconstr Surg 61:570–575
Santore RF, Kaufmann D, Robbins AJ, Dabezies EJ Jr (1997) Tissue expansion prior to revision total knee arthroplasty. J Arthroplasty 12:475–478
Weiß AP, Krackow KA (1993) Persistent wound drainage after primary total knee arthroplasty. J Arthroplasty 8:285–289
Winiarsky R, Barth P, Lotke P (1998) Total knee arthroplasty in morbidly obese patients. J Bone Jt Surg 80-A:1770–1774
Abdel-Salam, Eytes K (1995) Effects of tourniquet during total knee arthroplasty. J Bone Jt Surg 77:250–254
Brandjes DPM, Heljbor H, Büller HR, De Rik M, Jagt J, Ten Cate JW (1992) Acenocoumarol and heparin compared with acenocoumarol alone in the initial treatment of proximal- vein thrombosis. N Engl J Med 327:1485–1489
Cohen JR, Grella L, Citron M (1992) Greenfield filter instead of heparin as primary treatment for deep venous thrombosis or pulmonary embolism in patients with cancer. Cancer 70:1993–1996
Greinacher A (1999) Heparin-induzierte Thrombozytopenie. In: Müller-Berghaus G, Pötsch B (Hrsg) Hämostaseologie. Springer, Berlin, S 83–94
Haas S, Haas P (1996) Niedermolekulare Heparine — Die Anwendung in Klinik und Praxis. ZEIT-Verlag, Steinen
Habscheidt W (1991) Die bildgebende Sonographie in der Diagnostik der tiefen Beinvenenthrombose, Schattauer, Stuttgart
Kemkes-Mattes B, Oehler G (1996) Blutgerinnung und Throm-bose. Thieme, Stuttgart New York
Koopman MMW, Prandoni P, Piovella et. al. (1996) Treatment of venous thrombosis with intravenous unfractionated heparin administered in the hospital as compared with subcutaneous low-molecular weight heparin administered at home. N Engl J Med 334:682–687
Leyvraz PF, Bachmann F, Hoek J, Büller HR, Postel M, Samama M, Vandenbroek MD (1991) Prevention of deep vein thrombosis after hip replacement: randomised comparison between unfractionated heparin and low molecular weight heparin. Br Med J 303:543–548
Lynch AJ, Baker PL, Polly RE, Lepse PS, Wallace BE, Roudybsush D, Sund K, Lynch NM (1990) Mechanical measures in the Prophylaxis of postoperative thromboembolism in total knee arthroplasty. Clin Orthop 260:24–29
Murray DW, Britton AR, Bulstrode CJK (1996) Thrombopro- phylaxis and death after total hip replacement. J Bone Jonit Surg. 78-B:863–870
National Institutes of Health Consensus Development Conference Statement (1986) Prevention of venous thrombosis and pulmonary embolism. J Am Med Ass 256:744–749
Partsch H (1996) Diagnose und Therapie der tiefen Venenthrombose. Vasa 46 [Suppl]:l–53
Rader GP, Kramer C, Hendrich C, König A, Gohlke F, Eulert J (1998) Erfahrungen mit einer Sprunggelenksbewegungsschiene in der Thromboseprophylaxe bei Patienten nach totalendoprothetischem Kniegelenksersatz. Z Orthop 138:52–57
Rader CP, Kramer C, Hendrich C, König A, Eulert J (1998) Low molecular weight heparin and PTT adjusted unfractioned heparin in thromboprophylaxis after total knee and total hip arthroplasty. J Arthroplasty 13:180–185
Rader CP, Kramer C, König A, Gohlke F, Eulert J (1997) Vergleich zwischen niedermolekularen und unfraktionierten Heparinen (PPT-gesteuert) in der Thromboseprophylaxe bei Patienten mit totalendoprothetischem Ersatz von Hüft- und Kniegelenk. Z Orthop 135:52–57
Schöndorf TH (1978) Thrombembolieprophylaxe mit Heparin bei elektiven Hüftgelenkoperationen. Deutsch Med Wochenschrift 103:1877–1881
Seitz R, Egbring R (1995) Diagnostische Kriterien der disseminierten intravasalen Gerinnung. Hämostaseologie 15:65–68
Staubesand J, Heisterkamp T, Stege H (1995) Use of duplex sonography to investigate the effect of active and passive movement on the ankle joints for promoting venous return. Clin Anatomy 8:96–101
Stenzinger W, Van de Loo J (1999) Therapie mit oralen Antikoagulantien. In: Müller-Berghaus G, Pötsch B (Hrsg) Hämostaseologie. Springer, Berlin, S 666–683
Stulberg BN, Insall JN, Williams GW, Ghelman B (1984) Deep- vein thrombosis following total knee replacement. J Bone Jt Surg 66-A:194–201
Breed A (1974) Experimental production of vascular hypotension, and bone marrow and fat embolism with methylmethacrylat cement. Clin Orthop 102:227–244
Fahmy NR, Chandler HP, Danylchuk K, Matta EB, Sunder N, Siliski JM (1990) Blood-gas and circulatory changes during total knee replacement. J Bone J-t Surg 72-A:19–26
Hofmann S, Huemer G, Kratochwill C, Koller-Strametz J, Hopf R, Schlag G, Salzer M (1995a) Pathophysiologie der Fettembolie in der Orthopädie und Traumatologie. Orthopäde 24:84–94
Hofmann S, Hopf R, Huemer G, Kratochwill Ch, Koller-Strametz J, Schlag G, Salzer M (1995b) Modifizierte Opera-tionstechniken zur Reduzierung der Knochenmarkauschüttung in der Knieendoprothetik. Orthopäde 24:144–151
Hofmann S, Hopf R, Huemer G, Kratochwill C, Koller-Strametz J, Schlag G, Salzer M (1995c) Modifizierte Operationstechnik zur Reduzierung der Knochenmarkausschüttungen in der zementfreien Hüftendoprothetik. Orthopäde 24:130–138
Huemer G, Hofmann S, Kratochwill C, Koller-Stramezt J, Hopf R, Schlag G, Salzer M (1995) Therapeutische Ansätze zur Behandlung des Fettemboliesyndroms. Orthopäde 24:173–178
Monto RR, Carcia J, Callaghan JJ (1990) Fatal fat embolism follwoing total condylar knee arthroplasty. J Arthroplasty 5:291–299
Orsini EC, Byrick RJ, Müllen JB, Kay JC, Waddell JP (1987) Cardiopulmonary function and pulmonary microemboli during arthroplasty using cemented or non-cemented components. J Bone Jt Surg 69-A:822–832
Ulrich C, Burri C, Wörsdörfer O, Heinrich H (1986) Intraoperative transesophageal two-dimensional echocardiography in total hip replacement. Arch Orthop Surg 105:274–278
Wenda K, Ritter G, Ahlers J, von Issendorf WD (1990) Nachweis und Effekte von Knochenmarkeinschwemmungen bei Operationen im Bereich der Femurmarkhöhle. Unfallchirurg 93:1–6
Wenda K, Lauer K, Boor S, Runkel M, Kreitner KF (1995) Gibt es in der Endoprothetik einen Zusammenhang zwischen intramedullärer Druckerhöhung, Knochenmark-einschwemmungen und tiefen Beinvenenthrombosen? Orthopäde 24:114–123
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Dennis, D.A., Szymanski, A.B. (2001). Komplikationen. In: Praxis der Knieendoprothetik. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-59518-9_22
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