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Endoprothetik bei aseptischer Femurkopfnekrose

Total hip replacement in avascular femoral head necrosis

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Zusammenfassung

Hintergrund

Bei der aseptischen Femurkopfnekrose (FKN) handelt es sich um eine progredient verlaufende Perfusionsstörung des Hüftkopfes. Im Verlauf der FKN kommt es häufig zu einem strukturellen Schaden des betroffenen Gelenks, sodass die Implantation einer Hüftgelenksprothese notwendig ist.

Ziel

Der vorliegende Artikel soll den Lesern einen Überblick über die aktuelle Literatur zum Thema Endoprothetik bei Patienten mit FKN geben.

Ergebnisse

Bis in die 1990er-Jahre zeigten sich bei Patienten mit FKN erhöhte Revisionsraten nach Implantation einer Hüftgelenksendoprothese. Aktuelle Untersuchungen weisen jedoch keine signifikanten Unterschiede mehr in den klinischen Ergebnissen nach Hüftprothesenimplantation bei FKN und primärer Arthrose auf. Sichere Verankerungsformen sind zementierte und zementfreie Implantate mit verschiedenen Gleitpaarungsmöglichkeiten.

Zusammenfassung

Trotz des jungen Patientenalters kann auch bei Patienten mit einer FKN nach Implantation einer Hüftgelenksendoprothese mit guten langfristigen klinischen Ergebnissen gerechnet werden.

Abstract

Background

Avascular necrosis of the femoral head is a progressive perfusion disorder of the hip joint. Progress in avascular necrosis causes structural damage to the affected joint, often requiring total hip replacement.

Aim

This article is intended to give the reader an overview of the current literature on total hip replacement of patients with an avascular necrosis of the femoral head.

Results

Before 1990, patients with avascular necrosis of the femoral head had significantly higher revision rates after total hip replacement. Recent studies, however, showed no significant differences in clinical outcomes after total hip replacement in femoral head necrosis and primary osteoarthritis.

Summary

Despite the young age of the patients, good long-term clinical results can be expected even in patients with an avascular necrosis of the femoral head after total hip replacement.

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Abbreviations

ARCO:

Association Research Circulation Osseous

BLD:

Beinlängendifferenz

FKN:

Aseptische Femurkopfnekrose

TEP:

Totalendoprothese

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Authors and Affiliations

  1. Klinik für Orthopädie, Uniklinik RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Deutschland

    M. Betsch, M. Tingart, A. Driessen, V. Quack & B. Rath

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  1. M. Betsch
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  2. M. Tingart
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  3. A. Driessen
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  4. V. Quack
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Correspondence to M. Betsch.

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Interessenkonflikt

M. Betsch, M. Tingart, A. Driessen, V. Quack und B. Rath geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Betsch, M., Tingart, M., Driessen, A. et al. Endoprothetik bei aseptischer Femurkopfnekrose. Orthopäde 47, 751–756 (2018). https://doi.org/10.1007/s00132-018-3617-5

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