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Klinische Ergebnisse nach minimal-invasiver Hüftendoprothetik

Clinical results of minimally invasive total hip arthroplasty

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An Erratum to this article was published on 25 November 2012

Zusammenfassung

Ziel

Es wurde eine Darstellung und Auswertung der aktuellen Literatur der klinischen Ergebnisse unter besonderer Berücksichtigung der verschiedenen aktuell angewendeten Verfahren nach minimal-invasiver Hüftendoprothetik vorgenommen.

Methode

In einer Medline-Recherche wurden Studien analysiert, die klinische Ergebnisse nach Implantation einer Hüfttotalendoprothesen(HTEP)-Implantation darstellten. Besonderer Fokus würde auf einen möglichst hohen Evidence-based-medicine(EBM)-Level gelegt. Es wurden Daten von Studien zwischen 2007 bis 2011 berücksichtigt. Wir untersuchten die vorliegenden Arbeiten nach klinischen Scores, Ganganalysen, postoperativen Schmerzangaben und anderen Scores.

Ergebnisse

Es wurden insgesamt 24 Studien (davon 19 vergleichende) mit insgesamt 801 minimal-invasiv (MIS) operierten und 695 konventionell operierten Hüften untersucht. In nahezu allen Studien zeigte sich eine Überlegenheit der MIS- gegenüber den konventionellen Gruppen in Bezug auf postoperative Schmerzen, Blutverlust und rasche Rehabilitation. Diese Vorteile waren nach 3 bis 6 Monaten weitestgehend verschwunden. Die Komplikationsraten waren in beiden Gruppen nie signifikant unterschiedlich. Die klinischen Scores (z. B. Harris Hip Score) zeigten nach 3 bis 6 Monaten zumeist keinen signifikanten Unterschied.

Schlussfolgerung

Die vorliegenden Studien zeigen für alle MIS-Zugänge Vorteile in der frühen postoperativen Phase gegenüber den konventionellen Hüftzugängen. Diese verschwinden nach etwa 3 bis 6 Monaten. Bei vergleichbarem Risiko für Komplikationen bieten die MIS-Zugänge Vorteile in der frühen postoperativen Phase und Rehabilitation.

Abstract

Aim

This article presents an analysis and review of recent literature with a focus on clinical results after minimally invasive (MIS) total hip arthroplasty (THA) and with special attention to the different approaches currently used.

Methods

An online database (Medline) search for clinical trials after THA between 2007 and 2011 was performed with a special focus on prospective controlled randomized trials focusing on THA with a MIS approach. The data were analyzed for pain, blood loss, complications, gait analysis, Harris hip and other scores.

Results

A total of 24 studies (19 comparative studies) were included in this study with a total of 801 MIS THA cases and 695 conventionally operated hips. Almost every study showed superior results for the MIS group with respect to postoperative pain, blood loss and rehabilitation but these advantages almost totally disappeared after 3–6 months. The complication rate was comparable in both groups. After 3–6 months the clinical scores, such as the Harris hip score did not show any differences between conventional and MIS groups.

Conclusions

In this present study all MIS approaches showed advantages over the conventional surgical approach but these benefits disappeared after 3–6 months. With comparable risks for complications, MIS surgical approaches are superior in the early postoperative phase and rehabilitation.

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Authors and Affiliations

  1. Klinik für Orthopädie und orthopädische Chirurgie, Universitätsklinikum des Saarlandes, Kirrberger Straße, Gebäude 37, 66421, Homburg/Saar, Deutschland

    J. Jung, K. Anagnostakos & D. Kohn

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  1. J. Jung
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  2. K. Anagnostakos
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  3. D. Kohn
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Correspondence to J. Jung.

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An erratum to this article can be found online at http://dx.doi.org/10.1007/s00132-012-2030-8

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Jung, J., Anagnostakos, K. & Kohn, D. Klinische Ergebnisse nach minimal-invasiver Hüftendoprothetik. Orthopäde 41, 399–406 (2012). https://doi.org/10.1007/s00132-011-1895-2

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