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Periprothetische Frakturen bei Patienten mit rheumatoider Arthritis

Periprosthetic fractures in patients with rheumatoid arthritis

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Zusammenfassung

Postoperative periprothetische Frakturen sind seltene, aber schwerwiegende Komplikationen nach Endoprothesenimplantation. Wegen der oft schlechten Knochenqualität, dem multiplen Gelenkbefall mit häufig mehrfacher endoprothetischer Versorgung und dem Bestehen von Begleiterkrankungen besitzen Patienten mit rheumatoider Arthritis (RA) einerseits ein erhöhtes Risiko für periprothetische Frakturen, anderseits stellen diese Frakturen beim Rheumapatienten aus eben diesen Gründen oft auch ein besonders schwierig zu behandelndes Problem dar, das ein interdisziplinäres Herangehen an die Behandlung erforderlich macht. Die folgende Arbeit gibt anhand der aktuellen Literatur einen Überblick über die Epidemiologie, Klassifikation, Therapiemöglichkeiten und Behandlungsergebnisse von periprothetischer Frakturen und geht dabei auf die Besonderheiten bei Patienten mit RA ein.

Abstract

Postoperative periprosthetic fracture is a rare but serious complication after joint replacement surgery. Due to poor bone quality, multiple joint involvement with the replacement of different joints and considerable comorbidity, the presence of rheumatoid arthritis is associated with a high risk of periprosthetic fractures. For the same reasons, periprosthetic fractures in patients with rheumatoid arthritis can be very difficult to treat, and their management often requires an interdisciplinary approach.

On the basis of the current literature, the present work describes different aspects of the epidemiology of periprosthetic fractures, principles of their classification, different treatment options and the results of treatment of these fractures. Special attention is paid to the situation of patients with rheumatoid arthritis.

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  1. Orthopädische Universitätsklinik Magdeburg, Leipziger-Straße 44, 39120, Magdeburg, Deutschland

    G. Pap & H.W. Neumann

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Pap, G., Neumann, H. Periprothetische Frakturen bei Patienten mit rheumatoider Arthritis. Z Rheumatol 66, 20–27 (2007). https://doi.org/10.1007/s00393-006-0137-1

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