Zusammenfassung
Die Zahl der Revisionsoperationen nach künstlichem Gelenkersatz des Hüftgelenks steigt stetig. Die Rekonstruktionsverfahren stellen hohe Ansprüche an den Operateur und die verwendeten Implantatsysteme. Neue Entwicklungen aus der Forschung und Industrie erweitern die Möglichkeiten zur Versorgung der Patienten. Der vorliegende Artikel soll einen Überblick über den „state of the art“ der Revisionsendoprothetik des Hüftgelenks geben und neue Trends aufzeigen.
Abstract
Revision surgery after total hip arthroplasty is increasing steadily in numbers. These procedures demand high performance from both the treating surgeon as well as the implants used. Novel developments from basic research and industrial partners extend the possibilities for treating affected patients. This article gives an overview of the state of the art in revision hip arthroplasty: new techniques and trends are outlined and presented.
Literatur
Strobel C, Bormann N, Kadow-Romacker A et al (2011) Sequential release kinetics of two (gentamicin and BMP-2) or three (gentamicin, IGF-I and BMP-2) substances from a one-component polymeric coating on implants. J Control Release 156:37–45
Della Valle CJ, Paprosky WG (2004) The femur in revision total hip arthroplasty evaluation and classification. Clin Orthop Relat Res 420:55–62
Deml M, Ascherl R, Nöth U et al (2010) Klinische Langzeitergebnisse eines zementfreien, modularen Hüftrevisionsschaftendoprothesensystems aus einer prospektiven Multi-Center-Studie. Deutscher Kongress für Orthopädie und Unfallchirurgie 2010. German Medical Science GMS, Berlin
Erli HJ, Marx R, Paar O et al (2003) Surface pretreatments for medical application of adhesion. Biomed Eng Online 2:15
Garbuz D, Morsi E, Mohamed N et al (1996) Classification and reconstruction in revision acetabular arthroplasty with bone stock deficiency. Clin Orthop Relat Res 324:98–107
Gollwitzer H, Diehl P, Gerdesmeyer L et al (2006) Diagnostic strategies in cases of suspected periprosthetic infection of the knee. A review of the literature and current recommendations. Orthopade 35:904–916
Goosen JH, Kums AJ, Kollen BJ et al (2009) Porous-coated femoral components with or without hydroxyapatite in primary uncemented total hip arthroplasty: a systematic review of randomized controlled trials. Arch Orthop Trauma Surg 129:1165–1169
Gravius S, Mumme T, Andereya S et al (2007) The morse taper junction in modular revision hip replacement. Z Orthop Unfall 145:157–160
Gravius S, Pagenstert G, Weber O et al (2009) Acetabular defect reconstruction in revision surgery of the hip. Autologous, homologous or metal? Orthopade 38:729–740
Gravius S, Wimmer M, Deml M et al (2010) Femoral revision with impaction grafting with the uncemented MRP-TITAN revision stem: results of a prospective controlled study of 243 patients. Swiss Med Wkly 140 (Suppl 181):25
Gruner A, Heller KD (2009) Revision hip arthroplastiy of the hip joint. Revision of the femur: which implant is indicated when? Orthopade 38:667–680
Guyen O, Pibarot V, Vaz G et al (2009) Use of a dual mobility socket to manage total hip arthroplasty instability. Clin Orthop Relat Res 467:465–472
Habenicht G (2009) Kleben: Grundlagen, Technologien, Anwendungen. Springer, Berlin Heidelberg New York
Hummel MT, Malkani AL, Yakkanti MR et al (2009) Decreased dislocation after revision total hip arthroplasty using larger femoral head size and posterior capsular repair. J Arthroplasty 24:73–76
Issack PS, Nousiainen M, Beksac B et al (2009) Acetabular component revision in total hip arthroplasty. Part II: management of major bone loss and pelvic discontinuity. Am J Orthop (Belle Mead NJ) 38:550–556
Izquierdo RJ, Northmore-Ball MD (1994) Long-term results of revision hip arthroplasty. Survival analysis with special reference to the femoral component. J Bone Joint Surg [Br] 76:34–39
Jamsen E, Huhtala H, Puolakka T et al (2009) Risk factors for infection after knee arthroplasty. A register-based analysis of 43,149 cases. J Bone Joint Surg [Am] 91:38–47
Jasty M, Maloney WJ, Bragdon CR et al (1990) Histomorphological studies of the long-term skeletal responses to well fixed cemented femoral components. J Bone Joint Surg [Am] 72:1220–1229
Katthagen BD, Prub A (2008) Bone allografting. Orthopade 37:764–771
Kavanagh BF, Ilstrup DM, Fitzgerald RH Jr (1985) Revision total hip arthroplasty. J Bone Joint Surg [Am] 67:517–526
Ketonis C, Barr S, Adams CS et al (2011) Vancomycin bonded to bone grafts prevents bacterial colonization. Antimicrob Agents Chemother 55:487–494
Kittinger C, Marth E, Windhager R et al (2011) Antimicrobial activity of gentamicin palmitate against high concentrations of Staphylococcus aureus. J Mater Sci Mater Med 22:1447–1453
Kwong LM, Jasty M, Harris WH (1993) High failure rate of bulk femoral head allografts in total hip acetabular reconstructions at 10 years. J Arthroplasty 8:341–346
Lappalainen R, Santavirta SS (2005) Potential of coatings in total hip replacement. Clin Orthop Relat Res 46:72–79
Leopold SS, Rosenberg AG, Bhatt RD et al (1999) Cementless acetabular revision. Evaluation at an average of 10.5 years. Clin Orthop Relat Res 369:179–186
Mahoney CR, Fehringer EV, Kopjar B et al (2005) Femoral revision with impaction grafting and a collarless, polished, tapered stem. Clin Orthop Relat Res 432:181–187
Marx R (1987) Causes of failure of adhesives in adhesive bridges. Schweiz Monatsschr Zahnmed 97:1081–1086
Maurer TB, Ochsner PE (2006) Infected knee arthroplasty. A treatment algorithm at the Kantonsspital Liestal, Switzerland. Orthopade 35:917–928
Meding JB, Galley MR, Ritter MA (2010) High survival of uncemented proximally porous-coated titanium alloy femoral stems in osteoporotic bone. Clin Orthop Relat Res 468:441–447
Müller-Rath R, Wirtz DC, Siebert CH et al (2008) Amphiphilic bonder improves adhesion at the acrylic bone cement-bone interface of cemented acetabular components in total hip arthroplasty: in vivo tests in an ovine model. Arch Orthop Trauma Surg 128:701–707
Mumme T, Gravius S, Andereya S et al (2007) Improvement of the long-term adhesive strength between bone cement and bone in cemented cup arthroplasty: ex-vivo study. Arch Orthop Trauma Surg 127:409–416
Mumme T, Marx R, Müller-Rath R et al (2008) Surface pretreatment of endoprostheses by silica/silane to optimise the hydrolytic stability between bone cement and metal. Total hip and knee arthroplasty. Orthopade 37:240–250
Mumme T, Marx R, Müller-Rath R et al (2008) Surface coating to improve the metal-cement bonding in cemented femur stems. Arch Orthop Trauma Surg 128:773–781
Mumme T, Müller-Rath R, Andereya S et al (2007) Uncemented femoral revision arthroplasty using the modular revision prosthesis MRP-TITAN revision stem. Oper Orthop Traumatol 19:56–77
Musil R, Tiller HJ (1989) Silicoater procedures after 5-year clinical trial. Zahnarztl Prax 40:124–128
Niehaus AJ, Anderson DE, Samii VF et al (2009) Effects of orthopedic implants with a polycaprolactone polymer coating containing bone morphogenetic protein-2 on osseointegration in bones of sheep. Am J Vet Res 70:1416–1425
Paprosky WG, Lawrence JM, Cameron HU (1990) Acetabular defect classification: clinical application. Orthop Rev 19 (Suppl 1):3–16
Pekkarinen J, Alho A, Lepisto J et al (2000) Impaction bone grafting in revision hip surgery. A high incidence of complications. J Bone Joint Surg [Br] 82:103–107
Ritschl P, Halhammer F (2008) Experten-Statement: Protheseninfektionen in der Orthopädie. Osterr Arzteztg (Suppl 2):1–16
Sanchez Marquez JM, Del Sel N, Leali A et al (2009) Case reports: tantalum debris dispersion during revision of a tibial component for TKA. Clin Orthop Relat Res 467:1107–1110
Schramm M, Wirtz DC, Holzwarth U et al (2000) The morse taper junction in modular revision hip replacement. A biomechanical and retrieval analysis. Biomed Tech (Berl) 45:105–109
Schreurs BW, Spierings PT, Huiskes R et al (1988) Effects of preparation techniques on the porosity of acrylic cements. Acta Orthop Scand 59:403–409
Springer BD, Fehring TK, Griffin WL et al (2009) Why revision total hip arthroplasty fails. Clin Orthop Relat Res 467:166–173
Starker M, Kandziora F, Jager A et al (1998) Acetabular reconstruction using acetabular reinforcement rings. Orthopade 27:366–374
Steinbrink K, Frommelt L (1995) Treatment of periprosthetic infection of the hip using one-stage exchange surgery. Orthopade 24:335–343
Weeden SH, Schmidt RH (2007) The use of tantalum porous metal implants for Paprosky 3A and 3B defects. J Arthroplasty 22:151–155
Wirtz DC, Niethard FU (1997) Etiology, diagnosis and therapy of aseptic hip prosthesis loosening – a status assessment. Z Orthop Ihre Grenzgeb 135:270–280
Wolf CF, Gu NY, Doctor JN et al (2011) Comparison of one and two-stage revision of total hip arthroplasty complicated by infection: a Markov expected-utility decision analysis. J Bone Joint Surg [Am] 93:631–639
Zimmerli W, Trampuz A, Ochsner PE (2004) Prosthetic-joint infections. N Engl J Med 351:1645–1654
Interessenkonflikt
Der korrespondierende Autor gibt an, dass kein Interessenkonflikt besteht.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Gravius, S., Randau, T. & Wirtz, D. Was tun, wenn die Hüftendoprothese versagt?. Orthopäde 40, 1084–1094 (2011). https://doi.org/10.1007/s00132-011-1844-0
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00132-011-1844-0