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Die Orthopädie

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01.07.2015 | Coxarthrose | Leitthema

Endoprothese bei Dysplasiecoxarthrose

Problemorientierte Versorgungsstrategien

verfasst von: Prof. Dr. K.P. Günther, M. Stiehler, J. Goronzy, W. Schneiders, A. Hartmann

Erschienen in: Die Orthopädie | Ausgabe 7/2015

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Zusammenfassung

Hintergrund

Coxarthrosen aufgrund einer Hüftdysplasie sind häufig und können mit Deformitäten von Azetabulum und proximalem Femur assoziiert sein, die eine von der Standardendoprothetik abweichende Versorgung erforderlich machen.

Ziel der Arbeit

Basierend auf dem Schweregrad knöcherner und weichteiliger Veränderungen soll ein Überblick über gegenwärtige Versorgungsstrategien gegeben werden.

Material und Methodik

Zusätzlich zur Darstellung eigener Erfahrungen werden die Ergebnisse eines Literaturüberblicks präsentiert, die wesentliche Arbeiten zum Thema zusammenfassen.

Ergebnisse

Die sorgfältige präoperative Planung (basierend auf klinischer und röntgenologischer Untersuchung) hat große Bedeutung für ein gutes Operationsergebnis. Die Pfannenpositionierung möglichst nahe am primären Hüftzentrum zeigt die besten Ergebnisse. Eine Pfannendachaugmentation oder eine verstärkte Medialisierung unterstützen bei ausgeprägter Dysplasie die erforderliche knöcherne Überdachung des Implantates. Bei hoher Hüftluxation kann die subtrochantäre Verkürzungsosteotomie die Reposition erleichtern und das Risiko eines Nervenschadens reduzieren.

Diskussion

Auch wenn die postoperative Komplikationsrate bei Dysplasieversorgungen generell etwas höher als bei idiopathischer Arthrose ist, sind mittel- und langfristige Ergebnisse hinsichtlich Funktion und Standzeiten weitgehend vergleichbar.

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Titel: Endoprothese bei Dysplasiecoxarthrose
Problemorientierte Versorgungsstrategien
verfasst von: Prof. Dr. K.P. Günther
M. Stiehler
J. Goronzy
W. Schneiders
A. Hartmann
Publikationsdatum: 01.07.2015
Verlag: Springer Berlin Heidelberg
Schlagwörter: Coxarthrose
Hüftgelenkluxation
Arthritis
Endoprothetik
Erschienen in: Die Orthopädie / Ausgabe 7/2015
Print ISSN: 2731-7145
Elektronische ISSN: 2731-7153
DOI: https://doi.org/10.1007/s00132-015-3106-z

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Springer Medizin

Endoprothese bei Dysplasiecoxarthrose

Problemorientierte Versorgungsstrategien

Zusammenfassung

Hintergrund

Ziel der Arbeit

Material und Methodik

Ergebnisse

Diskussion

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Springer Medizin

Zusammenfassung

Hintergrund

Ziel der Arbeit

Material und Methodik

Ergebnisse

Diskussion

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