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19.12.2017 | Knochendefekte | Leitthema

Allogene Knochentransplantation in der Hüftrevisionsendoprothetik

Indikationen und Rekonstruktionsmöglichkeiten

verfasst von: Dr. G. A. Ahmed, B. Ishaque, M. Rickert, C. Fölsch

Erschienen in: Die Orthopädie | Ausgabe 1/2018

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Zusammenfassung

Mit der steigenden Anzahl von Endoprothesenträgern wird die Revision von Hüftendoprothesen weiter zunehmen. Die Rekonstruktion ossärer Defekte mit allogenen Knochen ermöglicht die Wiederherstellung eines knöchernen Lagers und verbessert die langfristige Verankerung und die Resultate. Eine ausreichende Primärstabilität des gewählten Konstrukts ist Voraussetzung für ein gutes klinisches Ergebnis und die langfristige ossäre Integration, ebenso wie ein guter Kontakt des implantierten Knochens zum Knochenlager. Die Knochentransplantation kann zu einem „Down-Grading“ eines knöchernen azetabulären Defekts beitragen und die Verwendung eines größeren Stützimplantats vermeiden. Auch bei der Rekonstruktion femoraler Defekte kann die Knochentransplantation das Knochenlager verbessern und die Implantation eines kleineren Schafts ermöglichen, allerdings sind der Indikationsstellung bei sehr ausgeprägten Defektzonen Grenzen gesetzt. Aufgrund der guten langfristigen Ergebnisse der modularen Revisionsschäfte hat sich das „Impaction-Bone-Grafting“ im Bereich des Schaftes nicht generell etabliert.

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Titel: Allogene Knochentransplantation in der Hüftrevisionsendoprothetik
Indikationen und Rekonstruktionsmöglichkeiten
verfasst von: Dr. G. A. Ahmed
B. Ishaque
M. Rickert
C. Fölsch
Publikationsdatum: 19.12.2017
Verlag: Springer Medizin
Schlagwörter: Knochendefekte
Hüft-TEP
Hüft-TEP
Erschienen in: Die Orthopädie / Ausgabe 1/2018
Print ISSN: 2731-7145
Elektronische ISSN: 2731-7153
DOI: https://doi.org/10.1007/s00132-017-3506-3

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