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Arthritis und Rheuma 2011; 31(01): 7-14
DOI: 10.1055/s-0037-1618044
Degenerative Erkrankungen des Fußes
Schattauer GmbH

Die Destruktion am oberen Sprunggelenk nach Larsen-Stadium V

Pro EndoprotheseDestruction of the upper ankle joint according Larsen’s stage VPro endoprothesis
S. Schill
1   MVZ-Gelenkzentrum Rosenheim, Schön Klinik Harthausen, Bad Aibling
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Publication History

Publication Date:
21 December 2017 (online)

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Zusammenfassung

In den vergangenen 15 Jahren wurden entscheidende Fortschritte im Hinblick auf Design und Technik der Sprunggelenksprothetik erreicht. Die vorliegenden 10-Jahresergebnisse mit Überlebensraten zwischen 70 und 90 Prozent und die spätere Rückzugsmöglichkeit zum Prothesenwechsel oder zur Arthrodese lassen heute die Endoprothese des oberen Sprunggelenks zunehmend in den Versorgungsschwerpunkt treten. Gerade der Rheumapatient mit seinem allgemein geringeren physischen Anforderungsprofil kann nach einer gut implantierten Prothese über zehn bis zwölf Jahre mit einer schmerzfreien Funktion des operierten Sprunggelenks rechnen. Die rekonstruktive Versorgung mit einer Sprunggelenksendoprothese ermöglicht dem Rheumapatienten im Vergleich zur Fusion eine wesentlich schnellere Remobilisierung mit Erhalt der Abrollvorgänge und Korrekturmöglichkeiten im Sprunggelenk. Die Arthrodese verbleibt als wertvolle therapeutische Alternative bei schweren Destruktionen mit knöchernen Substanzverlusten und Instabilitäten sowie als Rückzugsmöglichkeit nach Fehlschlägen der Endoprothetik.

Summary

In the past 15 years, major progress has been achieved in terms of design and technique of ankle prostheses. The present results with 10 years survival rates between 70 and 90 % and the possible revision to implant exchange or arthrodesis are the reasons for increasing importance of ankle arthroplasty. Especially the rheumatoid patients with their generally lower physical requirements can expect a pain-free function of the operated ankle for 10 to 12 years. In comparison to fusion, ankle arthroplasty allows the rheumatoid a significantly faster remobilization and reserves the correction capabilities of the ankle. Arthrodesis remains a valuable therapeutic alternative for severe bony destruction and instabilities, as well as a retreat for failures of arthroplasty.

Schlüsselwörter

Rheumatoide Arthritis - Sprunggelenksendoprothese - Sprunggelenksarthrodese

Keywords

Rheumatoid arthritis - ankle arthroplasty - ankle fusion
 

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