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Arthroskopie

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01.02.2022 | Hüftdysplasie | Leitthema

Reorientierende Beckenosteotomie bei azetabulärer Dysplasie – Wo stehen wir heute?

verfasst von: PD Dr. J. Schröder, C. Gatzka, J. Goronzy

Erschienen in: Arthroskopie | Ausgabe 1/2022

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Zusammenfassung

Hintergrund

Trotz flächendeckender Screeninguntersuchung nach der Geburt zeigt sich auch heute eine relevante Anzahl an symptomatischen Hüftdysplasien im jungen Erwachsenenalter. Die Dysplasie ist damit weiterhin eine führende präarthrotische Deformität am Hüftgelenk.

Methoden

Die reorientierende Beckenosteotomie stellt aktuell die erste Wahl in der Behandlung dar. Im deutschsprachigen Raum sind die periazetabuläre Osteotomie (PAO) und die Dreifach-Beckenosteotomie (3FBO) die dominierenden Techniken. Beide erlauben eine dreidimensionale Reorientierung des azetabulären Fragments und die individuelle Korrektur der Deformität bei angesichts der Komplexität des Eingriffs relativ niedriger Komplikationsrate.

Ergebnisse

Durch die Beckenosteotomie kann bei korrekter Indikationsstellung eine signifikante, über Jahrzehnte anhaltende Beschwerdebesserung und Verzögerung der Degeneration des Gelenks für die Patienten erreicht werden. Negative Prädiktoren eines Behandlungserfolgs sind v. a. das präoperative Patientenalter und der präoperative Arthrosegrad.

Schlussfolgerung

Für eine frühzeitige Diagnosestellung ist eine anhaltende Sensitivität gegenüber der Hüftdysplasie und für die Aufklärung der Patienten die Kenntnis der chirurgischen gelenkerhaltenden Möglichkeiten von großer Bedeutung.

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Titel: Reorientierende Beckenosteotomie bei azetabulärer Dysplasie – Wo stehen wir heute?
verfasst von: PD Dr. J. Schröder
C. Gatzka
J. Goronzy
Publikationsdatum: 01.02.2022
Verlag: Springer Medizin
Schlagwörter: Hüftdysplasie
Coxarthrose
Coxarthrose
Erschienen in: Arthroskopie / Ausgabe 1/2022
Print ISSN: 0933-7946
Elektronische ISSN: 1434-3924
DOI: https://doi.org/10.1007/s00142-021-00508-0

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